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Session: ePoster Monitor 3-Colon Cancer 2

eP422 - Does Hepatectomy Benefit Every Patient with Colorectal Liver Metastases?

Sunday, June 2, 2024
2:09 PM – 2:14 PM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Hiroshi Nagata, MD, PhD (he/him/his)

    Attending Surgeon
    Department of Colorectal Surgery, National Cancer Center Hospital
    Graduate School of Medicine, The University of Tokyo
    Chuo, Tokyo, Japan

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • YT

    Yasuyuki Takamizawa, Board Certified Surgeon, Board Certified Surgeon in Gastroenterology, General Clinical Oncologist (by JBCT)

    Medical staff, Colorectal Surgery Division
    National Cancer Center Hospital
    CHUO-KU, Tokyo, Japan

    Disclosure information not submitted.

  • Shunsuke Tsukamoto, MD

    Assistant chief
    Department of Colorectal Surgery, National Cancer Center Hospital
    National Cancer Center
    Chuo-ku, Tokyo, Japan

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • YK

    Yukihide Kanemitsu, MD

    Chief, Department of Colorectal Surgery
    National Cancer Center, Japan
    Tokyo, Tokyo, Japan

    Disclosure information not submitted.

Purpose/Background: Hepatectomy has been the curative treatment of choice for colorectal cancer liver metastases (CRCLM). However, it is the case only in a subset of patients and the majority develop recurrence shortly after surgery. It is not yet clear if every patient with technically resectable CRCLM should undergo liver resection.Methods/Interventions: This study included patients with CRCLM who visited National Cancer Center Hospital, Tokyo, Japan between 2017 and 2020. Overall survival was compared between patients who underwent resection (hepatectomy group) and those who did not (non-hepatectomy group), considering their clinicopathological features.Results/Outcomes: Out of 287 patients with CRCLM during the study period, 153 patients received treatment for their M1a disease. The three-year OS of the hepatectomy group (n = 99) was significantly better than that of the non-hepatectomy group (n=53) (79.3% vs 30.4%, p < 0.001). Subgroup analyses by patients’ clinicopathological features witnessed the survival advantage of the hepatectomy group on the whole, except for patients with rectal cancer (hazard ratio 0.70, 95% confidence interval 0.19-2.65) and those with cN2 (hazard ratio 0.46, 95% confidence interval 0.15-1.35). In multivariable analyses including age (≥65 or not), gender, primary tumor site (colon vs rectum), cT factor (cT4 or not), cN factor (cN2 or not), maximum tumor diameter (> 5 cm or not), number of liver lesions (≥ 10, 5–9, or 1–4), liver resection, chemotherapy, hepatectomy was the independent prognostic factor, and the interaction between liver resection and primary site (rectum vs. colon) was suggested (p for interaction =0 .105).Conclusion/

Discussion: While the survival advantage of hepatectomy was widely recognized in patients with CRCLM, the survival benefit of hepatectomy was less prominent in rectal cancer than in colon cancer. This study suggested that the indication of hepatectomy may differ between liver metastases of colon cancer and those of rectal cancer.