NEOADJUVANT TREATMENT OF LIVER METASTASES OF COLORECTAL CANCER: PREDICTIVE FACTORS OF PATHOLOGICAL RESPONSE

Area of Science:

• Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Neoadjuvant chemotherapy (CT) followed by surgery improves outcomes for colorectal liver metastases (CRLM).
• Accurate prediction of treatment response is crucial for optimizing patient management.

Purpose of the Study:

• To identify predictive factors for histological response in CRLM after neoadjuvant treatment.
• To guide selection of patients most likely to benefit from neoadjuvant strategies.

Main Methods:

• Retrospective monocentric study of 77 patients with CRLM undergoing surgery post-neoadjuvant therapy.
• Histological response assessed using Rubbia-Brandt tumor regression grading score.
• Analysis of predictive factors including time to metastasis and treatment regimen.

Main Results:

• 47% of patients showed a significant histological response (Group R).
• Histological response was associated with significantly greater overall survival (p=0.001).
• Predictive factors for response included delayed CRLM onset (>14 months) and combination neoadjuvant therapy (CT + targeted therapy).

Conclusions:

• Delayed CRLM onset and combined neoadjuvant CT with targeted therapy are independent predictors of favorable histological response.
• These factors can identify CRLM patients best suited for neoadjuvant treatment followed by surgical resection.