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ACE Inhibitor Therapy Does Not Influence the Survival Outcomes of Patients with Colorectal Liver Metastases Following
Sudip Sanyal1, Edward Alabraba1, Hussain Ibrahim1
1Department of Hepatobiliary and Pancreatic Surgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Rd, Nottingham, NG7 2UH, UK.
Background:
Angiotensin-converting enzyme (ACE) inhibitors have been shown to possibly influence the survival outcomes in certain cancers. The aim of this study was to evaluate the impact of ACE inhibitors on the outcomes of patients undergoing liver resection for colorectal liver metastases (CRLM). The secondary aim was to determine whether ACE inhibitors influenced histopathological changes in CRLM.
Methods:
Patients treated with liver resection for CRLM over a 13-year period were identified from a prospectively maintained database. Data including demographics, primary tumour treatment, surgical data, histopathology analysis and clinical outcome were collated and analysed.
Results:
A total of 586 patients underwent primary hepatic resections for CRLM during this period including 100 patients on ACE inhibitors. The median follow-up period was 23 (range: 12-96) months, in which 267 patients developed recurrent disease and 131 patients died. Independent predictors of disease-free survival on multivariate analysis included synchronous presentation, neoadjuvant chemotherapy, major liver resection, tumour size and number, extent of hepatic steatosis, R0 resection and presence of perineural invasion. Poorer overall survival was associated with neoadjuvant treatment, major liver resection, presence of multiple metastases, perineural invasion and positive resection margins on multivariate analysis. ACE inhibitors did not influence the survival outcome or histological presentation in CRLM.
Conclusion:
The use of ACE inhibitors did not affect the survival outcome or tumour biology in patients with CRLM following liver resection.
Insights
Angiotensin-converting enzyme (ACE) inhibitors did not impact survival or tumor biology in patients undergoing liver resection for colorectal liver metastases (CRLM). This study found no significant effect on disease-free or overall survival outcomes.
Area of Science:
- Oncology
- Pharmacology
- Surgical Oncology
Background:
- Angiotensin-converting enzyme (ACE) inhibitors are investigated for their potential influence on cancer survival.
- Colorectal liver metastases (CRLM) represent a significant challenge in oncology.
- Understanding factors affecting CRLM outcomes is crucial for patient management.
Purpose of the Study:
- To assess the impact of ACE inhibitors on patient outcomes after liver resection for CRLM.
- To investigate whether ACE inhibitors affect histopathological changes in CRLM.
- To identify predictors of survival and recurrence in CRLM patients.
Main Methods:
- Retrospective analysis of 586 patients undergoing liver resection for CRLM over 13 years.
- Data collected included demographics, treatment, surgical details, and histopathology.
- Multivariate analysis identified independent predictors of disease-free and overall survival.
Main Results:
- ACE inhibitors were used by 100 of 586 patients.
- No significant difference in survival outcomes or histological presentation was observed between patients on ACE inhibitors and those not.
- Independent predictors of survival included synchronous presentation, neoadjuvant chemotherapy, major liver resection, tumor characteristics, and resection margin status.
Conclusions:
- ACE inhibitors do not appear to influence survival outcomes in patients with CRLM undergoing liver resection.
- The use of ACE inhibitors did not alter tumor biology or histopathological features in this patient cohort.
- Further research may be needed to fully elucidate the role of ACE inhibitors in cancer treatment.
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