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Published on: March 3, 2023
501
Optimizing the selection of technically unresectable colorectal liver metastases
Kosuke Kobayashi1, Yosuke Inoue1, Yuki Kitano1
1Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Surgery
|November 17, 2022
Summary
Conversion surgery for unresectable colorectal liver metastases significantly improves survival. A new predictive model using KRAS status, tumor number, hepatic vein contact, and resectable sections aids in patient selection and prognosis assessment.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Colorectal liver metastases (CLM) pose challenges for surgical resection.
- Predicting suitability for conversion surgery in unresectable CLM is not well-established.
Purpose of the Study:
- To develop a predictive model for conversion surgery in patients with technically unresectable CLM.
- To assess the long-term outcomes of conversion surgery for unresectable CLM.
Main Methods:
- Retrospective analysis of 892 patients undergoing chemotherapy for CLM (2014-2021).
- Development of a predictive model based on factors including KRAS status, tumor number, hepatic vein contact, and resectable sections.
- Comparison of outcomes between patients who did and did not undergo conversion surgery.
Main Results:
- Conversion surgery was performed in 61 of 122 patients with initially unresectable CLM.
- Median overall survival was significantly higher in the conversion surgery group (5.6 years) versus the nonconversion group (1.8 years).
- The predictive model (AUC 0.889) identified patient subgroups with varying conversion rates and survival outcomes.
Conclusions:
- Conversion surgery offers improved prognoses for selected patients with technically unresectable CLM.
- The developed predictive model is valuable for identifying suitable candidates for conversion surgery and predicting patient outcomes.
