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Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time

BACKGROUND: Resection of colorectal liver metastases (CLM) has been established as the standard of care. This study aims to compare the change in clinicopathological characteristics of patients who underwent curative resection of CLM across two time periods—2000 to 2010 (P1) and 2011 to 2016 (P2) an...

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Autores principales: Chen, Lionel, Syn, Nicholas L., Goh, Brian K. P., Cheow, Peng Chung, Raj, Prema, Koh, Yexin, Chung, Alexander, Lee, Ser Yee, Ooi, London Lucien, Chan, Chung Yip, Teo, Jin Yao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650267/
https://www.ncbi.nlm.nih.gov/pubmed/32883292
http://dx.doi.org/10.1186/s12957-020-01984-8
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author Chen, Lionel
Syn, Nicholas L.
Goh, Brian K. P.
Cheow, Peng Chung
Raj, Prema
Koh, Yexin
Chung, Alexander
Lee, Ser Yee
Ooi, London Lucien
Chan, Chung Yip
Teo, Jin Yao
author_facet Chen, Lionel
Syn, Nicholas L.
Goh, Brian K. P.
Cheow, Peng Chung
Raj, Prema
Koh, Yexin
Chung, Alexander
Lee, Ser Yee
Ooi, London Lucien
Chan, Chung Yip
Teo, Jin Yao
author_sort Chen, Lionel
collection PubMed
description BACKGROUND: Resection of colorectal liver metastases (CLM) has been established as the standard of care. This study aims to compare the change in clinicopathological characteristics of patients who underwent curative resection of CLM across two time periods—2000 to 2010 (P1) and 2011 to 2016 (P2) and evaluate the prognostic impact of these characteristics on survival outcomes. METHODS: Patients who undergo liver resection for CLM at Singapore General Hospital from January 2000 to December 2016 were identified from a prospectively maintained database. The primary end point was overall survival. RESULTS: There were 183/318 (57.5%) patients and 135/318 (42.5%) patients in P1 and P2, respectively. There was a lower proportion of patients who had nodal metastases from primary colorectal cancer and clinical risk score (CRS) less than 3 in P2 when compared to P1. There was no difference in survival between both time periods. Independent predictors of survival for the cohort were CEA levels ≥ 200 ng/ml, primary tumour grade and lymph nodal status. Independent predictors of poor survival in P1 were poorly differentiated colorectal cancer and nodal metastases while in P2, independent predictors of poor survival were multiple liver metastases and nodal metastases. CONCLUSION: Nodal metastases from primary colorectal cancer are an independent predictor of poor survival across time for resectable CLM. Although there is no difference in survival between the two time periods, patients with multiple liver metastases should be carefully considered prior to surgery as it is also an independent predictor of overall survival.
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spelling pubmed-76502672020-11-09 Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time Chen, Lionel Syn, Nicholas L. Goh, Brian K. P. Cheow, Peng Chung Raj, Prema Koh, Yexin Chung, Alexander Lee, Ser Yee Ooi, London Lucien Chan, Chung Yip Teo, Jin Yao World J Surg Oncol Research BACKGROUND: Resection of colorectal liver metastases (CLM) has been established as the standard of care. This study aims to compare the change in clinicopathological characteristics of patients who underwent curative resection of CLM across two time periods—2000 to 2010 (P1) and 2011 to 2016 (P2) and evaluate the prognostic impact of these characteristics on survival outcomes. METHODS: Patients who undergo liver resection for CLM at Singapore General Hospital from January 2000 to December 2016 were identified from a prospectively maintained database. The primary end point was overall survival. RESULTS: There were 183/318 (57.5%) patients and 135/318 (42.5%) patients in P1 and P2, respectively. There was a lower proportion of patients who had nodal metastases from primary colorectal cancer and clinical risk score (CRS) less than 3 in P2 when compared to P1. There was no difference in survival between both time periods. Independent predictors of survival for the cohort were CEA levels ≥ 200 ng/ml, primary tumour grade and lymph nodal status. Independent predictors of poor survival in P1 were poorly differentiated colorectal cancer and nodal metastases while in P2, independent predictors of poor survival were multiple liver metastases and nodal metastases. CONCLUSION: Nodal metastases from primary colorectal cancer are an independent predictor of poor survival across time for resectable CLM. Although there is no difference in survival between the two time periods, patients with multiple liver metastases should be carefully considered prior to surgery as it is also an independent predictor of overall survival. BioMed Central 2020-09-03 /pmc/articles/PMC7650267/ /pubmed/32883292 http://dx.doi.org/10.1186/s12957-020-01984-8 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Chen, Lionel
Syn, Nicholas L.
Goh, Brian K. P.
Cheow, Peng Chung
Raj, Prema
Koh, Yexin
Chung, Alexander
Lee, Ser Yee
Ooi, London Lucien
Chan, Chung Yip
Teo, Jin Yao
Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
title Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
title_full Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
title_fullStr Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
title_full_unstemmed Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
title_short Impact of multidisciplinary tumour boards (MTB) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
title_sort impact of multidisciplinary tumour boards (mtb) on the clinicopathological characteristics and outcomes of resected colorectal liver metastases across time
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650267/
https://www.ncbi.nlm.nih.gov/pubmed/32883292
http://dx.doi.org/10.1186/s12957-020-01984-8
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