Embryonic origin of primary colon cancer predicts survival in patients undergoing ablation for colorectal liver metastases

S. Yamashita, B. C. Odisio, S. Y. Huang, S. E. Kopetz, K. Ahrar, Y. S. Chun, C. Conrad, T. A. Aloia, S. Gupta, S. Harmoush, M. E. Hicks, J. N. Vauthey

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background In patients with primary colorectal cancer (CRC) or unresectable metastatic CRC, midgut embryonic origin is associated with worse prognosis. The impact of embryonic origin on survival after ablation of colorectal liver metastases (CLM) is unclear. Methods We identified 74 patients with CLM who underwent percutaneous ablation during 2004–2015. Survival and recurrence after ablation of CLM from midgut origin (n = 18) and hindgut origin (n = 56) were analyzed. Prognostic value of embryonic origin was evaluated. Results Recurrence-free survival (RFS) and overall survival (OS) after percutaneous ablation were worse in patients from midgut origin (3-year RFS: 5.6% vs. 24%, P = 0.004; 3-year OS: 25% vs. 70%, P 0.001). In multivariable analysis, factors associated with worse OS were midgut origin (hazard ratio [HR] 4.87, 95% CI 2.14–10.9, P 0.001), multiple CLM (HR 2.35, 95% CI 1.02–5.39, P = 0.044), and RAS mutation (HR 2.78, 95% CI 1.25–6.36, P = 0.013). At a median follow-up of 25 months, 56 patients (76%) had developed recurrence, 16 (89%) with midgut origin and 40 (71%) with hindgut origin (P = 0.133). Recurrent disease was treated with local therapy in 20 patients (36%), 2 (13%) with midgut origin and 18 (45%) with hindgut origin (P = 0.022). Conclusion Compared to CLM from hindgut origin tumors, CLM from midgut origin tumors were associated with worse survival after ablation, which was partly attributable to the fact that patients with hindgut origin were more frequently candidates for local therapy at recurrence.

Original languageEnglish (US)
Pages (from-to)1040-1049
Number of pages10
JournalEuropean Journal of Surgical Oncology
Volume43
Issue number6
DOIs
StatePublished - Jun 2017

Keywords

  • Ablation
  • Colorectal liver metastases
  • Embryonic origin of primary colon cancer
  • Primary colon cancer
  • Survival in patients

ASJC Scopus subject areas

  • Surgery
  • Oncology

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