Gao Z, Wu SK, Zhang SJ, Wang X, Wu YC, Jin X. Adjuvant chemotherapy for isolated resectable colorectal lung metastasis: A retrospective study using inverse probability treatment weighting propensity analysis. World J Gastrointest Surg 2024; 16(10): 3171-3184 [PMID: 39575266 DOI: 10.4240/wjgs.v16.i10.3171]
Corresponding Author of This Article
Xuan Jin, PhD, Department of Medical Oncology, Peking University First Hospital, No. 8 Xishiku Street, Beijing 10034, China. jinxuanbdyy@outlook.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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/
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3171-3184 Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3171
Adjuvant chemotherapy for isolated resectable colorectal lung metastasis: A retrospective study using inverse probability treatment weighting propensity analysis
Zhao Gao, Shi-Kai Wu, Shi-Jie Zhang, Xin Wang, Ying-Chao Wu, Xuan Jin
Zhao Gao, Shi-Kai Wu, Xuan Jin, Department of Medical Oncology, Peking University First Hospital, Beijing 100034, China
Shi-Jie Zhang, Department of Thoracic Surgery, Peking University First Hospital, Beijing 100034, China
Xin Wang, Ying-Chao Wu, Department of Gastrointestinal Surgery, Peking University First Hospital, Beijing 100034, China
Author contributions: Gao Z and Jin X prepared the manuscript; Wu SK, Wang X and Jin X conceived the review, and edited the manuscript; Gao Z collected and analyzed the data; Zhang SJ and Wu YC analyzed the data and drafted the manuscript; All the authors have read and approved the final version of the manuscript.
Supported by the National Project for Clinical Key Specialty Development.
Institutional review board statement: Our study complies with all ethical regulations of the Peking University First Hospital Ethics Committee, Approval No. 2024-321-001.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xuan Jin, PhD, Department of Medical Oncology, Peking University First Hospital, No. 8 Xishiku Street, Beijing 10034, China. jinxuanbdyy@outlook.com
Received: May 11, 2024 Revised: August 17, 2024 Accepted: August 29, 2024 Published online: October 27, 2024 Processing time: 140 Days and 3.5 Hours
Abstract
BACKGROUND
The benefit of adjuvant chemotherapy (ACT) for patients with no evidence of disease after pulmonary metastasis resection (PM) from colorectal cancer (CRC) remains controversial.
AIM
To assess the efficacy of ACT in patients after PM resection for CRC.
METHODS
This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July 2023. The primary endpoint was overall survival (OS); secondary endpoints included cancer-specific survival (CSS) and disease-free survival (DFS). An inverse probability of treatment-weighting (IPTW) analysis was conducted to address indication bias. Survival outcomes compared using Kaplan-Meier curves, log-rank test, Cox regression and confirmed by propensity score-matching (PSM).
RESULTS
With a median follow-up of 27.5 months (range, 18.3-50.4 months), the 5-year OS, CSS and DFS were 72.0%, 74.4% and 51.3%, respectively. ACT had no significant effect on OS after PM resection from CRC [original cohort: P = 0.08; IPTW: P = 0.15]. No differences were observed for CSS (P = 0.12) and DFS (P = 0.68) between the ACT and non-ACT groups. Multivariate analysis showed no association of ACT with better survival, while sublobar resection (HR = 0.45; 95%CI: 0.20-1.00, P = 0.049) and longer disease-free interval (HR = 0.45; 95%CI: 0.20-0.98, P = 0.044) were associated with improved survival.
CONCLUSION
ACT does not improve survival after PM resection for CRC. Further well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.
Core Tip: It remains controversial whether patients who have reached no evidence disease after resection of pulmonary metastasis of colorectal cancer (CRC) can benefit from adjuvant chemotherapy (ACT). We aimed to evaluate the efficacy of ACT in patients after resection of pulmonary metastasis resection from CRC. Due to the lack of randomized prospective trials and high level evidence, our study may support valuable data support for individual participant data meta-analysis and help further research on this type of disease.
