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The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival
INTRODUCTION: The disease-free interval (DFI) between resection of primary colorectal cancer (CRC) and diagnosis of liver metastases is considered an important prognostic indicator; however, recent analyses in metastatic CRC found limited evidence to support this notion. OBJECTIVE: The current study...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682566/ https://www.ncbi.nlm.nih.gov/pubmed/31147988 http://dx.doi.org/10.1245/s10434-019-07481-x |
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author | Höppener, Diederik J. Nierop, Pieter M. H. van Amerongen, Martinus J. Olthof, Pim B. Galjart, Boris van Gulik, Thomas M. de Wilt, Johannes H. W. Grünhagen, Dirk J. Rahbari, Nuh N. Verhoef, Cornelis |
author_facet | Höppener, Diederik J. Nierop, Pieter M. H. van Amerongen, Martinus J. Olthof, Pim B. Galjart, Boris van Gulik, Thomas M. de Wilt, Johannes H. W. Grünhagen, Dirk J. Rahbari, Nuh N. Verhoef, Cornelis |
author_sort | Höppener, Diederik J. |
collection | PubMed |
description | INTRODUCTION: The disease-free interval (DFI) between resection of primary colorectal cancer (CRC) and diagnosis of liver metastases is considered an important prognostic indicator; however, recent analyses in metastatic CRC found limited evidence to support this notion. OBJECTIVE: The current study aims to determine the prognostic value of the DFI in patients with resectable colorectal liver metastases (CRLM). METHODS: Patients undergoing first surgical treatment of CRLM at three academic centers in The Netherlands were eligible for inclusion. The DFI was defined as the time between resection of CRC and detection of CRLM. Baseline characteristics and Kaplan–Meier survival estimates were stratified by DFI. Cox regression analyses were performed for overall (OS) and disease-free survival (DFS), with the DFI entered as a continuous measure using a restricted cubic spline function with three knots. RESULTS: In total, 1374 patients were included. Patients with a shorter DFI more often had lymph node involvement of the primary, more frequently received neoadjuvant chemotherapy for CRLM, and had higher number of CRLM at diagnosis. The DFI significantly contributed to DFS prediction (p =0.002), but not for predicting OS (p =0.169). Point estimates of the hazard ratio (95% confidence interval) for a DFI of 0 versus 12 months and 0 versus 24 months were 1.284 (1.114–1.480) and 1.444 (1.180–1.766), respectively, for DFS, and 1.111 (0.928–1.330) and 1.202 (0.933–1.550), respectively, for OS. CONCLUSION: The DFI is of prognostic value for predicting disease recurrence following surgical treatment of CRLM, but not for predicting OS outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1245/s10434-019-07481-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6682566 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-66825662019-08-19 The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival Höppener, Diederik J. Nierop, Pieter M. H. van Amerongen, Martinus J. Olthof, Pim B. Galjart, Boris van Gulik, Thomas M. de Wilt, Johannes H. W. Grünhagen, Dirk J. Rahbari, Nuh N. Verhoef, Cornelis Ann Surg Oncol Colorectal Cancer INTRODUCTION: The disease-free interval (DFI) between resection of primary colorectal cancer (CRC) and diagnosis of liver metastases is considered an important prognostic indicator; however, recent analyses in metastatic CRC found limited evidence to support this notion. OBJECTIVE: The current study aims to determine the prognostic value of the DFI in patients with resectable colorectal liver metastases (CRLM). METHODS: Patients undergoing first surgical treatment of CRLM at three academic centers in The Netherlands were eligible for inclusion. The DFI was defined as the time between resection of CRC and detection of CRLM. Baseline characteristics and Kaplan–Meier survival estimates were stratified by DFI. Cox regression analyses were performed for overall (OS) and disease-free survival (DFS), with the DFI entered as a continuous measure using a restricted cubic spline function with three knots. RESULTS: In total, 1374 patients were included. Patients with a shorter DFI more often had lymph node involvement of the primary, more frequently received neoadjuvant chemotherapy for CRLM, and had higher number of CRLM at diagnosis. The DFI significantly contributed to DFS prediction (p =0.002), but not for predicting OS (p =0.169). Point estimates of the hazard ratio (95% confidence interval) for a DFI of 0 versus 12 months and 0 versus 24 months were 1.284 (1.114–1.480) and 1.444 (1.180–1.766), respectively, for DFS, and 1.111 (0.928–1.330) and 1.202 (0.933–1.550), respectively, for OS. CONCLUSION: The DFI is of prognostic value for predicting disease recurrence following surgical treatment of CRLM, but not for predicting OS outcomes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1245/s10434-019-07481-x) contains supplementary material, which is available to authorized users. Springer International Publishing 2019-05-30 2019 /pmc/articles/PMC6682566/ /pubmed/31147988 http://dx.doi.org/10.1245/s10434-019-07481-x Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Colorectal Cancer Höppener, Diederik J. Nierop, Pieter M. H. van Amerongen, Martinus J. Olthof, Pim B. Galjart, Boris van Gulik, Thomas M. de Wilt, Johannes H. W. Grünhagen, Dirk J. Rahbari, Nuh N. Verhoef, Cornelis The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival |
title | The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival |
title_full | The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival |
title_fullStr | The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival |
title_full_unstemmed | The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival |
title_short | The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival |
title_sort | disease-free interval between resection of primary colorectal malignancy and the detection of hepatic metastases predicts disease recurrence but not overall survival |
topic | Colorectal Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682566/ https://www.ncbi.nlm.nih.gov/pubmed/31147988 http://dx.doi.org/10.1245/s10434-019-07481-x |
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