Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2017; 23(45): 8027-8034
Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8027
Impact of homogeneous pathologic response to preoperative chemotherapy in patients with multiple colorectal liver metastases
Charles Sabbagh, Denis Chatelain, Christophe Attencourt, Jean-Paul Joly, Bruno Chauffert, Cyril Cosse, Jean-Marc Regimbeau
Charles Sabbagh, Cyril Cosse, Jean-Marc Regimbeau, Department of Digestive and Oncologic Surgery, Amiens University Medical Center, 80054 Amiens, France
Charles Sabbagh, Cyril Cosse, INSERM U1088, Jules Verne University of Picardie, 80054 Amiens, France
Charles Sabbagh, Denis Chatelain, Bruno Chauffert, Jean-Marc Regimbeau, University of Picardie, 80054 Amiens, France
Denis Chatelain, Christophe Attencourt, Department of Anatomic Pathology, Amiens University Medical Center, 80054 Amiens, France
Jean-Paul Joly, Department of Hepatogastroenterology, Amiens University Medical Center, 80054 Amiens, France
Bruno Chauffert, Department of Medical Oncology, Amiens University Medical Center, 80054 Amiens, France
Jean-Marc Regimbeau, EA4294, Jules Verne University of Picardie, 80054 Amiens, France
Author contributions: Sabbagh C, Chatelain D, Attencourt C, Joly JP, Chauffert B, Cosse C and Regimbeau JM designed research and analyzed data; Sabbagh C, Chatelain D, Attencourt C, Cosse C and Regimbeau JM performed research and wrote the paper.
Institutional review board statement: The present study was reviewed and approved by the Commission Nationale de l’information et des libertés (CNIL) with the number DRCI T135.
Conflict-of-interest statement: None.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jean-Marc Regimbeau, MD, PhD, Professor, Department of Digestive and Oncologic Surgery, Amiens University Medical Center, Avenue Laennec, 80054 Amiens, France. regimbeau.jean-marc@chu-amiens.fr
Telephone: +33-322-668301 Fax: +33-322-668680
Received: June 20, 2017
Peer-review started: June 22, 2017
First decision: July 13, 2017
Revised: July 28, 2017
Accepted: September 6, 2017
Article in press: September 6, 2017
Published online: December 7, 2017
Processing time: 166 Days and 12.1 Hours
Abstract
AIM

To analyze the homogeneity of pathologic response to preoperative chemotherapy (PRPC) after chemotherapy in patients with multiple liver metastases (LM).

METHODS

From September 2011 to August 2014, patients with at least two LM undergoing preoperative chemotherapy prior to resection were included in this retrospective, single-center study. The endpoints were PRPC homogeneity (according to both the Rubbia-Brandt and MD Anderson classifications), the impact of PRPC on the MDT decision, factors associated with homogeneous PRPC and overall survival of patients with vs. without homogeneous PRPC.

RESULTS

seventy-three patients with a total of 88 liver resections (including 15 two-stage procedures) were included in the study. The homogeneous PRPC rate was 55% according to the Rubbia-Brandt classification and 53% according to the MD Anderson classification. The MDT decision was modified by the PRPC in only 2.7% of patients (n = 2).

CONCLUSION

The PRPC was homogeneous in only one half of patients and had very little influence on the MDT decision.

Keywords: Liver metastases; Pathological response; Homogeneity; Preoperative chemotherapy; Colorectal cancer

Core tip: Pathologic response to preoperative chemotherapy (PRPC) is correlated with survival after resection of liver metastases. This study analyzed the homogeneity of PRPC after chemotherapy in patients with multiple liver metastases. The study underlines that homogeneous PRPC rate was low (55% according to the Rubbia-Brandt classification and 53% according to the MD Anderson classification) and has little impact on the multidisciplinary team meeting decision (modified by the PRPC in only 2.7% of patients).