演題抄録

ワークショップ

開催概要
開催回
第58回・2020年・京都
 

切除不能大腸癌に対する薬物療法後のconversion surgeryの成績と予後因子

演題番号 : WS20-5

[筆頭演者]
江本 成伸:1 
[共同演者]
野澤 宏彰:1、村井 伸:1、川合 一茂:1、佐々木 和人:1、金子 学:1、室野 浩司:1、飯田 祐基:1、横山 雄一郎:1、石井 博章:1、安西 紘幸:1、園田 洋史:1、石原 聡一郎:1

1:東京大学・腫瘍外科

 

Aim: To investigate the clinical course and prognostic factors of patients who underwent conversion surgery for unresectable colorectal cancer after chemotherapy.
Methods: We retrospectively investigated the treatment course and clinicopathologic factors of 38 patients with unresectable colorectal cancer who underwent conversion surgery from 2007 to 2019.
Results: The background of 38 patients was male: female = 18:20, median age was 66 years (34-79 years), primary lesion was in right colon: left colon: rectum = 9:16:13, the histological type was differentiated in 37 cases and undifferentiated in 1 case. RAS was wild-type: mutant: untested = 24: 13: 1. Treatment order was primary excision → chemotherapy → metastase resection in 15 cases, chemotherapy → primary / metastase excision in 23 cases. Chemotherapy included oxaliplatin regimens in 37 patients and FOLFIRI in 1 patient, all of whom were combined with molecular target drugs (cetuximab in 11, panitumumab in 11, bevacizumab in 16). The median time from chemotherapy initiation to radical surgery was 103 days (43-912 days). Adjuvant chemotherapy (AC) was performed in 18 patients after radical surgery, and 13 of them were combined with molecular target drugs. Recurrence was observed in 29 of 38 cases (76%), and reexcision was performed in 17 cases. The median overall survival (OS) was 1927 days. Patient characteristics, localization of primary lesions, metastatic pattern, treatment sequence, and chemotherapy regimen did not correlate with prognosis. The recurrence-free survival rate (RFS) was significantly higher in patients with AC than those without AC (2-year RFS 12.0% vs. 33.3%, P = 0.0006). The OS also showed a favorable prognosis in the AC treated group (3-year survival rate 65.3% vs. 87.5%, 5-year survival rate 34.6% vs. 78.8%, P = 0.07).
Conclusions: The median OS of conversion cases for unresectable colorectal cancer was over 5 years. AC was also considered to be effective in suppressing recurrence.

キーワード

臓器別:大腸・小腸

手法別:集学的治療

前へ戻る