TY - JOUR
T1 - Survival Benefit of Repeat Local Treatment in Patients Suffering From Early Recurrence of Colorectal Cancer Liver Metastases
AU - Hellingman, Tessa
AU - Kuiper, Babette I.
AU - Buffart, Laurien M.
AU - Meijerink, Martijn R.
AU - Versteeg, Kathelijn S.
AU - Swijnenburg, Rutger-Jan
AU - van Delden, Otto M.
AU - Haasbeek, Cornelis J. A.
AU - de Vries, Jan J. J.
AU - van Waesberghe, Jan Hein T. M.
AU - Zonderhuis, Barbara M.
AU - van der Vliet, Hans J.
AU - Kazemier, Geert
N1 - Publisher Copyright: © 2021
PY - 2021/12
Y1 - 2021/12
N2 - Background: A uniform treatment strategy for patients suffering from early recurrence after local treatment of CRLM is currently lacking. The aim of this observational cohort study was to assess the potential survival benefit of repeat local treatment compared to systemic therapy in patients suffering from early recurrence of CRLM. Patients and Methods: Patients who developed recurrent CRLM within 12 months after initial local treatment with curative intent were retrospectively identified in Amsterdam University Medical Centers between 2009-2019. Differences in overall and progression-free survival among treatment strategies were assessed using multivariable Cox regression analyses. Results: A total of 135 patients were included. Median overall survival of 41 months [range 4-135] was observed in patients who received repeat local treatment, consisting of upfront or repeat local treatment after neoadjuvant systemic therapy, compared to 24 months [range 1-55] in patients subjected to systemic therapy alone (adjusted HR = 0.42 [95%-CI: 0.25-0.72]; P = .002). Prolonged progression-free survival was observed after neoadjuvant systemic therapy followed by repeat local treatment, as compared to upfront repeat local treatment in patients with recurrent CRLM within 4 months following initial local treatment of CRLM (adjusted HR = 0.36 [95%-CI: 0.15-0.86]; P = .021). Conclusion: Patients with early recurrence of CRLM should be considered for repeat local treatment strategies. A multimodality approach, consisting of neoadjuvant systemic therapy followed by repeat local treatment, appeared favorable in patients with recurrence within 4 months following initial local treatment of CRLM.
AB - Background: A uniform treatment strategy for patients suffering from early recurrence after local treatment of CRLM is currently lacking. The aim of this observational cohort study was to assess the potential survival benefit of repeat local treatment compared to systemic therapy in patients suffering from early recurrence of CRLM. Patients and Methods: Patients who developed recurrent CRLM within 12 months after initial local treatment with curative intent were retrospectively identified in Amsterdam University Medical Centers between 2009-2019. Differences in overall and progression-free survival among treatment strategies were assessed using multivariable Cox regression analyses. Results: A total of 135 patients were included. Median overall survival of 41 months [range 4-135] was observed in patients who received repeat local treatment, consisting of upfront or repeat local treatment after neoadjuvant systemic therapy, compared to 24 months [range 1-55] in patients subjected to systemic therapy alone (adjusted HR = 0.42 [95%-CI: 0.25-0.72]; P = .002). Prolonged progression-free survival was observed after neoadjuvant systemic therapy followed by repeat local treatment, as compared to upfront repeat local treatment in patients with recurrent CRLM within 4 months following initial local treatment of CRLM (adjusted HR = 0.36 [95%-CI: 0.15-0.86]; P = .021). Conclusion: Patients with early recurrence of CRLM should be considered for repeat local treatment strategies. A multimodality approach, consisting of neoadjuvant systemic therapy followed by repeat local treatment, appeared favorable in patients with recurrence within 4 months following initial local treatment of CRLM.
KW - Ablation
KW - Hepatectomy
KW - Survival analysis
KW - Systemic therapy
KW - Treatment strategy
UR - http://www.scopus.com/inward/record.url?scp=85113832995&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.clcc.2021.07.007
DO - https://doi.org/10.1016/j.clcc.2021.07.007
M3 - Article
C2 - 34462211
SN - 1533-0028
VL - 20
SP - e263-e272
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
IS - 4
ER -