TY - JOUR
T1 - Embryonic origin of primary colon cancer predicts survival in patients undergoing ablation for colorectal liver metastases
AU - Yamashita, S.
AU - Odisio, B. C.
AU - Huang, S. Y.
AU - Kopetz, S. E.
AU - Ahrar, K.
AU - Chun, Y. S.
AU - Conrad, C.
AU - Aloia, T. A.
AU - Gupta, S.
AU - Harmoush, S.
AU - Hicks, M. E.
AU - Vauthey, J. N.
N1 - Funding Information:
The authors thank Stephanie Deming, an employee of the Department of Scientific Publications, MD Anderson Cancer Center, for copyediting the manuscript and Ruth J. Haynes, an employee of the Department of Surgical Oncology, MD Anderson Cancer Center, for secretarial assistance in the preparation of the manuscript. This research was supported in part by the National Institutes of Health through MD Anderson's Cancer Center Support Grant, CA016672.
Publisher Copyright:
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2017/6
Y1 - 2017/6
N2 - 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.
AB - 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.
KW - Ablation
KW - Colorectal liver metastases
KW - Embryonic origin of primary colon cancer
KW - Primary colon cancer
KW - Survival in patients
UR - http://www.scopus.com/inward/record.url?scp=85011554777&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85011554777&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2017.01.007
DO - 10.1016/j.ejso.2017.01.007
M3 - Article
C2 - 28187878
AN - SCOPUS:85011554777
SN - 0748-7983
VL - 43
SP - 1040
EP - 1049
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 6
ER -