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Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases.

Publication ,  Journal Article
Blazer, DG; Kishi, Y; Maru, DM; Kopetz, S; Chun, YS; Overman, MJ; Fogelman, D; Eng, C; Chang, DZ; Wang, H; Zorzi, D; Ribero, D; Ellis, LM ...
Published in: J Clin Oncol
November 20, 2008

PURPOSE: The primary goal of this study was to evaluate whether pathologic response to chemotherapy predicts patient survival after preoperative chemotherapy and resection of colorectal liver metastases (CLM). The secondary goal of the study was to identify the clinical predictors of pathologic response. PATIENTS AND METHODS: A retrospective review was performed of 305 patients who underwent preoperative irinotecan- or oxaliplatin-based chemotherapy, followed by resection of CLM. Pathologic response was systematically evaluated and reported as the mean of the percentage of cancer cells remaining within each tumor. Univariate and multivariate analyses were performed to identify the predictors of pathologic response and survival. RESULTS: Cumulative 5-year overall survival rates by pathologic response status were as follows: 75% complete response (no residual cancer cells), 56% major response (1% to 49% residual cancer cells), and 33% minor response (> or = 50% residual cancer cells; complete v major response, P = .037; major v minor response, P = .028). Multivariate analysis revealed that only surgical margin status (P = .050; hazard ratio [HR], 1.77) and pathologic response (major response: P = .034; HR, 4.80; minor response: P = .007; HR, 6.93) were independent predictors of survival. Multivariate analysis of the predictors of pathologic response revealed that carcinoembryonic antigen level < or = 5 ng/mL, tumor size < or = 3 cm, and chemotherapy with fluoropyrimidine plus oxaliplatin and bevacizumab were independent predictors of pathologic response. CONCLUSION: Pathologic response predicts survival after preoperative chemotherapy and resection of CLM. Degree of pathologic response represents a new outcome end point for prognosis after resection of CLM.

Duke Scholars

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

November 20, 2008

Volume

26

Issue

33

Start / End Page

5344 / 5351

Location

United States

Related Subject Headings

  • Survival Rate
  • Oxaliplatin
  • Organoplatinum Compounds
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Irinotecan
  • Humans
  • Hepatectomy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Blazer, D. G., Kishi, Y., Maru, D. M., Kopetz, S., Chun, Y. S., Overman, M. J., … Vauthey, J.-N. (2008). Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases. J Clin Oncol, 26(33), 5344–5351. https://doi.org/10.1200/JCO.2008.17.5299
Blazer, Dan G., Yoji Kishi, Dipen M. Maru, Scott Kopetz, Yun Shin Chun, Michael J. Overman, David Fogelman, et al. “Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases.J Clin Oncol 26, no. 33 (November 20, 2008): 5344–51. https://doi.org/10.1200/JCO.2008.17.5299.
Blazer DG, Kishi Y, Maru DM, Kopetz S, Chun YS, Overman MJ, et al. Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases. J Clin Oncol. 2008 Nov 20;26(33):5344–51.
Blazer, Dan G., et al. “Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases.J Clin Oncol, vol. 26, no. 33, Nov. 2008, pp. 5344–51. Pubmed, doi:10.1200/JCO.2008.17.5299.
Blazer DG, Kishi Y, Maru DM, Kopetz S, Chun YS, Overman MJ, Fogelman D, Eng C, Chang DZ, Wang H, Zorzi D, Ribero D, Ellis LM, Glover KY, Wolff RA, Curley SA, Abdalla EK, Vauthey J-N. Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases. J Clin Oncol. 2008 Nov 20;26(33):5344–5351.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

November 20, 2008

Volume

26

Issue

33

Start / End Page

5344 / 5351

Location

United States

Related Subject Headings

  • Survival Rate
  • Oxaliplatin
  • Organoplatinum Compounds
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Irinotecan
  • Humans
  • Hepatectomy