Japan Digestive Disease Week 2022
International Session (Symposium)5 (JSGS, JSGE, JGES, JSH)
October 29, 14:30–17:00, Room 9 (Fukuoka International Congress Center 413+414)
IS-S5-7_S
Does surgical intervention contribute to survival for CRC with isolated PALN metastasis in the era of new anticancer drugs?
- 1
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
- 2
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute
Background:
New anticancer drugs render management decisions more complex rather than simply being a choice of surgery or systemic chemotherapy for advanced CRC.
Aims:
To clarify the current impact of surgical intervention for isolated para-aortic lymph node metastasis (PALNM) of CRC by a time-dependent analysis.
Patients and Methods:
Consecutive patients who received treatment for isolated PALNM between 2006 and 2021 were enrolled. After a simple comparison of patients for survival, a time-varying covariate (TVC) analysis was done to consider the time-varying nature of surgery after chemotherapy.
Results:
Data from 42 patients, including 19, 11, and 12 who received upfront surgery, conversion surgery following chemotherapy, and chemotherapy alone, were analyzed. Actual 5/10-year OS was 49.7%/33.1%, 62.5/50.0%, and 9.5/0%, respectively. In TVC analysis, estimated 5/10-year OS with surgery and chemotherapy was 53.9%/36.7% and 10.7%/0%, respectively, with a significant difference of p = 0.0049. Multivariate Cox model with TVC revealed significant impact of PALN resection on survival (HR 0.569, 95%CI 0.413 – 0.782, p = 0.001).
Conclusion:
Surgical intervention still plays an important role in treating isolated PALNM of CRC in the era of new anticancer drugs.
New anticancer drugs render management decisions more complex rather than simply being a choice of surgery or systemic chemotherapy for advanced CRC.
Aims:
To clarify the current impact of surgical intervention for isolated para-aortic lymph node metastasis (PALNM) of CRC by a time-dependent analysis.
Patients and Methods:
Consecutive patients who received treatment for isolated PALNM between 2006 and 2021 were enrolled. After a simple comparison of patients for survival, a time-varying covariate (TVC) analysis was done to consider the time-varying nature of surgery after chemotherapy.
Results:
Data from 42 patients, including 19, 11, and 12 who received upfront surgery, conversion surgery following chemotherapy, and chemotherapy alone, were analyzed. Actual 5/10-year OS was 49.7%/33.1%, 62.5/50.0%, and 9.5/0%, respectively. In TVC analysis, estimated 5/10-year OS with surgery and chemotherapy was 53.9%/36.7% and 10.7%/0%, respectively, with a significant difference of p = 0.0049. Multivariate Cox model with TVC revealed significant impact of PALN resection on survival (HR 0.569, 95%CI 0.413 – 0.782, p = 0.001).
Conclusion:
Surgical intervention still plays an important role in treating isolated PALNM of CRC in the era of new anticancer drugs.
- Index Term 1: advanced colorectal cancer
- Index Term 2: para-aortic lymph node metastasis