scholarly journals Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis

2020 ◽  
Author(s):  
Kosuke Ono ◽  
Tomoyuki Abe ◽  
Akihiko Ohshita ◽  
Yusuke Sumi ◽  
Takuya Yano ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Liver Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Colorectal Liver Metastasis ◽  
Vascular Invasion ◽  
Propensity Score Analysis ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Score Analysis

Abstract Background This study evaluated the impact of neoadjuvant chemotherapy on the prognosis of patients with resectable colorectal liver metastasis and assessed the usefulness of Beppu’s nomogram for predicting prognosis. Methods This retrospective study identified 88 consecutive inpatients who underwent primary hepatic resection for colorectal liver metastasis; 58 received neoadjuvant chemotherapy and 30 underwent upfront surgery. Factors associated with recurrence-free survival were identified via univariate and multivariate analysis. Propensity score analysis using inverse probability of treatment weighting was also performed. Results On univariate analysis, poor recurrence-free survival was associated with multiple tumors, advanced primary tumor stage, vascular invasion by the primary tumor, a Beppu score ≥ 6, and neoadjuvant chemotherapy. On multivariate analysis, a Beppu score ≥ 6 and neoadjuvant chemotherapy were independent risk factors for recurrence. Neoadjuvant chemotherapy recipients had a higher incidence of lymph node metastasis and vascular invasion than non-recipients. Propensity score analysis revealed no significant difference in the recurrence-free survival rate between these groups. Conclusions Our results show the usefulness of Beppu scores for predicting the prognosis of patients with colorectal liver metastasis, but do not support the use of neoadjuvant chemotherapy in these patients.

scholarly journals Efficacy of upfront hepatectomy without neoadjuvant chemotherapy for resectable colorectal liver metastasis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kosuke Ono ◽  
Tomoyuki Abe ◽  
Akihiko Oshita ◽  
Yusuke Sumi ◽  
Takuya Yano ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Liver Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Primary Tumor ◽  
Vascular Invasion ◽  
Propensity Score Analysis ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Score Analysis

Abstract Background Hepatectomy for resectable colorectal liver metastasis (CRLM) is recommended. However, the efficacy of upfront hepatectomy without neoadjuvant chemotherapy (NAC) is unclear due to the uncertainty of perioperative systemic chemotherapy. Moreover, it is crucial to predict the prognosis when considering perioperative chemotherapy. This study evaluated the impact of neoadjuvant chemotherapy on the prognosis of patients with resectable CRLM and assessed the usefulness of Beppu’s nomogram for predicting prognosis. Methods This retrospective study identified 88 consecutive inpatients who underwent primary hepatic resection for CRLM; 58 received neoadjuvant chemotherapy and 30 underwent upfront surgery. Factors associated with recurrence-free survival were identified via univariate and multivariate analysis. Furthermore, propensity score analysis using inverse probability of treatment weighting (IPTW) was performed. Results On univariate analysis, poor recurrence-free survival was associated with multiple tumors, advanced primary tumor stage, vascular invasion by the primary tumor, a Beppu’s nomogram score ≥ 6, and neoadjuvant chemotherapy. On multivariate analysis, a Beppu’s nomogram score ≥ 6 and neoadjuvant chemotherapy were independent risk factors for recurrence. Neoadjuvant chemotherapy recipients had a higher incidence of lymph node metastasis and vascular invasion than non-recipients. Propensity score analysis revealed no significant difference in the recurrence-free survival rate between these groups. Conclusions Our results show that upfront hepatectomy without neoadjuvant chemotherapy can be considered for resectable CRLM treatment. Beppu’s nomogram score can be a tool for predicting the prognosis of patients with CRLM.

scholarly journals Hepatectomyvsradiofrequency ablation for colorectal liver metastasis: A propensity score analysis

2015 ◽  
Vol 21 (11) ◽  
pp. 3300-3307 ◽  
Author(s):  
Huisong Lee ◽  
Jin Seok Heo ◽  
Yong Beom Cho ◽  
Seong Hyeon Yun ◽  
Hee Cheol Kim ◽  
...  
Keyword(s):  
Liver Metastasis ◽  
Propensity Score ◽  
Colorectal Liver Metastasis ◽  
Propensity Score Analysis ◽  
Score Analysis

scholarly journals Morbidity and mortality of lobectomy or pneumonectomy after neoadjuvant treatment: an analysis from the ESTS database

2019 ◽  
Author(s):  
Alessandro Brunelli ◽  
Gaetano Rocco ◽  
Zalan Szanto ◽  
Pascal Thomas ◽  
Pierre Emmanuel Falcoz
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Bronchopleural Fistula ◽  
Neoadjuvant Treatment ◽  
Mortality Rates ◽  
Induction Treatment ◽  
Score Analysis ◽  
Cardiopulmonary Complications ◽  
Lung Resections

Abstract OBJECTIVES To evaluate the postoperative complications and 30-day mortality rates associated with neoadjuvant chemotherapy before major anatomic lung resections registered in the European Society of Thoracic Surgeons (ESTS) database. METHODS Retrospective analysis on 52 982 anatomic lung resections registered in the ESTS database (July 2007–31 December 2017) (6587 pneumonectomies and 46 395 lobectomies); 5143 patients received neoadjuvant treatment (9.7%) (3993 chemotherapy alone and 1150 chemoradiotherapy). To adjust for possible confounders, a propensity case-matched analysis was performed. The postoperative outcomes (morbidity and 30-day mortality) of matched patients with and without induction treatment were compared. RESULTS 8.2% of all patients undergoing lobectomies and 20% of all patients undergoing pneumonectomies received induction treatment. Lobectomy analysis: propensity score analysis yielded 3824 pairs of patients with and without induction treatment. The incidence of cardiopulmonary complications was higher in the neoadjuvant group (626 patients, 16% vs 446 patients, 12%, P < 0.001), but 30-day mortality rates were similar (71 patients, 1.9% vs 75 patients, 2.0%, P = 0.73). The incidence of bronchopleural fistula and prolonged air leak >5 days were similar between the 2 groups (neoadjuvant: 0.5% vs 0.4%, P = 0.87; 9.2% vs 9.9%, P = 0.27). Pneumonectomy analysis: propensity score analysis yielded 1312 pairs of patients with and without induction treatment. The incidence of cardiopulmonary complications was higher in the treated patients compared to those without neoadjuvant treatment (neoadjuvant 275 cases, 21% vs 18%, P = 0.030). However, the 30-day mortality was similar between the matched groups (neoadjuvant 68 cases, 5.2% vs 5.3%, P = 0.86). Finally, the incidence of bronchopleural fistula was also similar between the 2 groups (neoadjuvant 1.8% vs 1.4%, P = 0.44). CONCLUSIONS Neoadjuvant chemotherapy is not associated with an increased perioperative risk after either lobectomy or pneumonectomy, warranting a more liberal use of this approach for patients with locally advanced operable lung cancer.

scholarly journals Neoadjuvant Chemotherapy Followed by Radiofrequency Ablation Prolongs Survival for Ablatable Colorectal Liver Metastasis: A Propensity Score Matching Comparative Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Yizhen Chen ◽  
Youyao Xu ◽  
Linwei Xu ◽  
Fang Han ◽  
Yurun Huang ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Metastasis ◽  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Tumor Progression ◽  
Propensity Score Matching ◽  
Progression Free Survival ◽  
Local Tumor Progression ◽  
Local Tumor ◽  
Free Survival

BackgroundTypically, colorectal liver metastasis (CRLM) is not a candidate for hepatectomy. Radiofrequency ablation (RFA) plays a critical role in unresectable CRLM patients. Nevertheless, high local tumor progression (LTP) and distant metastasis limit the development and further adoption and use of RFA. Neoadjuvant chemotherapy (NAC) has been widely used in resectable CRLM and is recommended by the guidelines. There are no studies on whether NAC can improve the prognosis in ablatable CRLM patients. The present study aimed to determine the feasibility and effectiveness of RFA plus NAC.MethodsThis retrospective cohort included CRLM patients from Zhejiang Cancer Hospital records, who received RFA from January 2009 to June 2020 and were divided into two groups according to the presence or absence of NAC. The Kaplan–Meier method was used to evaluate the 3-year local tumor progression-free survival (LTPFS), progression-free survival (PFS), and overall survival (OS) of the two groups. The propensity score matching was used to reduce bias when assessing survival. Multivariate Cox proportional hazards regression analysis was used to study the independent factors affecting LTPFS, PFS, and OS.ResultsA total of 149 CRLM patients (88 in the RFA alone group and 61 in the plus NAC group) fulfilled the inclusion criteria. Post-RFA complications were 3.4% in the RFA alone group and 16.4% in the plus NAC group. The 3-year LTPFS, PFS, and OS of the RFA only group were 60.9%, 17.7%, and 46.2%, respectively. The 3-year LTPF, PFS, and OS of the plus NAC group were 84.9%, 46.0%, and 73.6%, respectively. In the 29 pairs of propensity score matching cohorts, the 3-year LTPFS, PFS, and OS in the plus NAC group were longer than those in the RFA group (P &lt; 0.05). NAC was an independent protective factor for LTPFS, PFS, and OS (P &lt; 0.05).ConclusionsFor ablatable CRLM patients, RFA plus NAC obtained a better prognosis than RFA alone. Based on the current results, the application of NAC before RFA may become the standard treatment.

Influence of neoadjuvant chemotherapy on resection of primary colorectal liver metastases: A propensity score analysis

2017 ◽  
Vol 116 (2) ◽  
pp. 149-158 ◽  
Author(s):  
Moritz J. Strowitzki ◽  
Thomas Schmidt ◽  
Ulrich Keppler ◽  
Alina S. Ritter ◽  
Sarah Mahmoud ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Propensity Score ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Propensity Score Analysis ◽  
Score Analysis

Comparison of Nedaplatin- and Cisplatin-Based Concurrent Chemoradiotherapy in Locally Advanced Cervical Cancer Patients: A Propensity Score Analysis

2018 ◽  
Vol 28 (5) ◽  
pp. 1029-1037
Author(s):  
Ping Li ◽  
Rui Zhang ◽  
Zhihua Nie ◽  
Mengjuan Long ◽  
Gong Zhang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Propensity Score ◽  
Concurrent Chemoradiotherapy ◽  
Propensity Score Analysis ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Advanced Cervical Cancer ◽  
Free Survival ◽  
Locally Advanced Cervical Cancer ◽  
Score Analysis

PurposeThe aim of this study was to evaluate the efficacy of using nedaplatin to replace cisplatin for concurrent chemoradiotherapy (CCRT) in patients with newly diagnosed locally advanced cervical cancer.MethodsThe medical records of 155 patients with cervical cancer who had undergone CCRT with cisplatin (n = 85) or nedaplatin (n = 70) between January 2012 and January 2017 were retrospectively reviewed. Propensity score analysis with 1:1 matching with the nearest neighbor matching method was performed to assess response rates, progression-free survival, overall survival, and toxicity between 2 groups.ResultsPropensity score matching identified 63 patients in each group. After matching, compared with patients treated with cisplatin-based concurrent chemoradiotherapy (CisRT), we found that patients treated with nedaplatin-based concurrent chemoradiotherapy (NedaRT) had a significant higher recurrence rate (25.4% vs 42.9%; P = 0.04). In addition, the 3-year progression-free survival rate for NedaRT group was also worse than that for the CisRT group (52.2% vs 63.4%, P = 0.03). There was no difference in the overall response rates between the CisRT and NedaRT groups (87.3% and 90.5%, respectively; P = 0.57). The rates of 3-year overall survival and grades 3 to 4 toxicities were similar between the 2 groups.ConclusionsThe clinical outcome of this cohort of patients with locally advanced cervical cancer treated with CCRT did in no way provide support for the use of nedaplatin in place of cisplatin in chemoradiation and demonstrated no equivalence of the 2 drugs. Cautions should be taken for the replacement among platinum complexes in cancer treatment.

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