演題抄録

口演

開催概要
開催回
第58回・2020年・京都
 

大腸癌同時性肝転移切除症例における術後補助化学療法レジメン選択の意義

演題番号 : O28-3

[筆頭演者]
井 祐樹:1 
[共同演者]
杉本 起一:1、入江 宇大:1、塚本 亮一:1、呉 一眞:1、本庄 薫平:1、岡澤 裕:1、河合 雅也:1、河野 眞吾:1、宗像 慎也:1、高橋 玄:1、小島 豊:1、須郷 広之:2、冨木 裕一:1、坂本 一博:1

1:順天堂大学附属順天堂医院・下部消化管外科、2:順天堂大学附属練馬病院・総合外科

 

Introduction: Expansion of the indication for liver resection and new regimens for systemic chemotherapy have improved postoperative outcomes for synchronous colorectal liver metastases (CRLM). However, such cases can still have a high recurrence rate, even after curative resection. Therefore, there is a need for postoperative adjuvant chemotherapy (POAC) after liver resection in patients with CRLM. There are few studies of the efficacy of postoperative adjuvant chemotherapy (POAC) with an oxaliplatin-based regimen after simultaneous resection for colorectal cancer and synchronous colorectal liver metastases (CRLM) with curative intent.
Objective: The goal of the study was to compare POAC with oxaliplatin-based and fluoropyrimidine regimens using propensity score (PS) matching analysis.
Methods: 82 patients, who received POAC after simultaneous resection for colorectal cancer and synchronous CRLM, were placed in a L-OHP(+) group (POAC with an oxaliplatin-based regimen, n=39) and a L-OHP(-) group (POAC with a fluoropyrimidine regimen, n=43). Recurrence-free (RFS), cancer-specific (CSS), unresectable recurrence-free (URRFS), remnant liver recurrence-free (RLRFS), and extrahepatic recurrence-free (EHRFS) survival were analyzed.
Results: Before PS matching, the L-OHP(+) and (-) groups had no significant differences in RFS, CSS, URRFS, RLRFS, and EHRFS. Univariate analysis indicated significant differences in age, differentiation, number of hepatic lesions and maximum diameter of the hepatic lesion between the two groups. After PS matching using these confounders, RFS and RLRFS were significantly better among patients in the L-OHP(+) group compared with the L-OHP(-) group (HR: 0.43, 95% CI: 0.19-0.95, p=0.04; HR: 0.42, 95% CI: 0.18-0.98, p=0.04, respectively). However, there were no significant differences in CSS, URRFS and EHRFS between the two groups.
Conclusions: PS matching analysis demonstrated the efficacy of POAC with an oxaliplatin-based regimen in RFS and RLRFS.

キーワード

臓器別:大腸・小腸

手法別:化学療法

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