Japan Digestive Disease Week 2022
International Poster Session5 (JDDW)
October 28, 10:42–11:22, Room 15 (Marine Messe Fukuoka Arena Digital Poster Session)
IP-22_G
Postoperative recurrence patterns and longterm-outcomes of metastasis-directed therapy in colorectal cancer
- 1
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences Kumamoto University
Purpose: Oligometastasis is defined as metastasis to limited numbers in an organ. The importance of metastasis-directed therapy (MDT), including surgery, has been reported. The aim of this study was to evaluate long-term outcome of MDT in colorectal cancer (CRC).
Methods: Of 763 Stage I-III CRC patients who underwent radical surgery, 114 patients with recurrence were included.
Results: MDT was performed in 49/114 (43%) patients, in 9/14 (64%) local, 20/32 (63%) lung, 5/12 (51.7%) lymph node, 11/22 (50%) liver, 1/9 (11%) dissemination, and 3/25 (12%) for multiple-organs. MDT for re-recurrence sites was performed in 19/49 cases (39%), in 13 lungs, 4 liver, 1 local and 1 lymph node. The third MDT was performed in 4/19 cases (21%), 3 locals and 1 lung. Liver metastases was associated with early recurrence and 5-year-overall survival (OS) after recurrence was shorter in liver metastases, but longer in lung metastases. The median OS was 8.6 months with best-supportive-care and 24.3 months with palliative chemotherapy. However, 5-year-OS with MDT was 72%. Oligometastasis accounted for 52% of postoperative recurrences. MDT was performed in 23% multiple-metastases versus 86% oligometastasis. 5-year-OS rates of oligometastasis and multiple-metastases were 74% and 13%, respectively.
Conclusion: MDT was performed in 43% after recurrences. MDT was repeatedly performed for lung metastases and the prognosis was favorable. MDT was performed in 86% of oligometastasis, with a favorable outcome.
Methods: Of 763 Stage I-III CRC patients who underwent radical surgery, 114 patients with recurrence were included.
Results: MDT was performed in 49/114 (43%) patients, in 9/14 (64%) local, 20/32 (63%) lung, 5/12 (51.7%) lymph node, 11/22 (50%) liver, 1/9 (11%) dissemination, and 3/25 (12%) for multiple-organs. MDT for re-recurrence sites was performed in 19/49 cases (39%), in 13 lungs, 4 liver, 1 local and 1 lymph node. The third MDT was performed in 4/19 cases (21%), 3 locals and 1 lung. Liver metastases was associated with early recurrence and 5-year-overall survival (OS) after recurrence was shorter in liver metastases, but longer in lung metastases. The median OS was 8.6 months with best-supportive-care and 24.3 months with palliative chemotherapy. However, 5-year-OS with MDT was 72%. Oligometastasis accounted for 52% of postoperative recurrences. MDT was performed in 23% multiple-metastases versus 86% oligometastasis. 5-year-OS rates of oligometastasis and multiple-metastases were 74% and 13%, respectively.
Conclusion: MDT was performed in 43% after recurrences. MDT was repeatedly performed for lung metastases and the prognosis was favorable. MDT was performed in 86% of oligometastasis, with a favorable outcome.
- Index Term 1: Oligometastasis
- Index Term 2: Metastasis-directed therapy