Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy

Florian E Buisman; Wills F Filipe; Nancy E Kemeny; Raja R Narayan; Rami M Srouji; Vinod P Balachandran; Thomas Boerner; Jeffrey A Drebin; William R Jarnagin; T Peter Kingham; Alice C Wei; Dirk J Grünhagen; Cornelis Verhoef; Bas Groot Koerkamp; Michael I D'Angelica

doi:10.1245/s10434-020-08776-0

Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy

Florian E Buisman^*, Wills F Filipe, Nancy E Kemeny, Raja R Narayan, Rami M Srouji, Vinod P Balachandran, Thomas Boerner, Jeffrey A Drebin, William R Jarnagin, T Peter Kingham, Alice C Wei, Dirk J Grünhagen, Cornelis Verhoef, Bas Groot Koerkamp, Michael I D'Angelica

^*Corresponding author for this work

Surgery

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Abstract

BACKGROUND: The aim of this study was to investigate the effectiveness of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after complete resection or ablation of recurrent colorectal liver metastases (CRLM).

METHODS: A retrospective cohort study was conducted of patients from two centers who were treated with resection and/or ablation of recurrent CRLM only between 1992 and 2018. Overall survival (OS) and hepatic disease-free survival (hDFS) were estimated using the Kaplan-Meier method. The Cox regression method was used to calculate hazard ratios (HRs) with corresponding 95% confidence intervals (CI).

RESULTS: Of 374 eligible patients, 81 (22%) were treated with adjuvant HAIP chemotherapy. The median follow-up for survivors was 65 months (IQR 32-118 months). Patients receiving adjuvant HAIP were more likely to have multifocal disease and receive perioperative systemic chemotherapy at time of resection for recurrence. A median hDFS of 46 months (95% CI 29-81 months) was found in patients treated with adjuvant HAIP compared with 18 months (95% CI 15-26 months) in patients treated with resection and/or ablation alone (p = 0.001). The median OS and 5-year OS were 89 months (95% CI 52-126 months) and 66%, respectively, in patients treated with adjuvant HAIP compared with 57 months (95% CI 47-67 months) and 47%, respectively, in patients treated with resection and/or ablation only (p = 0.002). Adjuvant HAIP was associated with superior hDFS (adjusted HR 0.599, 95% CI 0.38-0.93, p = 0.02) and OS (adjusted HR 0.59, 95% CI 0.38-0.92, p = 0.02) in multivariable analysis.

CONCLUSION: Adjuvant HAIP chemotherapy after resection and/or ablation of recurrent CRLM is associated with superior hDFS and OS.

Original language	English
Pages (from-to)	808-816
Number of pages	9
Journal	Annals of Surgical Oncology
Volume	28
Issue number	2
Early online date	Jul 2020
DOIs	https://doi.org/10.1245/s10434-020-08776-0
Publication status	Published - Feb 2021

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© 2020, The Author(s).

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Buisman, F. E., Filipe, W. F., Kemeny, N. E., Narayan, R. R., Srouji, R. M., Balachandran, V. P., Boerner, T., Drebin, J. A., Jarnagin, W. R., Kingham, T. P., Wei, A. C., Grünhagen, D. J., Verhoef, C., Koerkamp, B. G., & D'Angelica, M. I. (2021). Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy. Annals of Surgical Oncology, 28(2), 808-816. https://doi.org/10.1245/s10434-020-08776-0

@article{8e74a9cb29204f9a9b911e72498054bb,

title = "Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy",

abstract = "BACKGROUND: The aim of this study was to investigate the effectiveness of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after complete resection or ablation of recurrent colorectal liver metastases (CRLM).METHODS: A retrospective cohort study was conducted of patients from two centers who were treated with resection and/or ablation of recurrent CRLM only between 1992 and 2018. Overall survival (OS) and hepatic disease-free survival (hDFS) were estimated using the Kaplan-Meier method. The Cox regression method was used to calculate hazard ratios (HRs) with corresponding 95% confidence intervals (CI).RESULTS: Of 374 eligible patients, 81 (22%) were treated with adjuvant HAIP chemotherapy. The median follow-up for survivors was 65 months (IQR 32-118 months). Patients receiving adjuvant HAIP were more likely to have multifocal disease and receive perioperative systemic chemotherapy at time of resection for recurrence. A median hDFS of 46 months (95% CI 29-81 months) was found in patients treated with adjuvant HAIP compared with 18 months (95% CI 15-26 months) in patients treated with resection and/or ablation alone (p = 0.001). The median OS and 5-year OS were 89 months (95% CI 52-126 months) and 66%, respectively, in patients treated with adjuvant HAIP compared with 57 months (95% CI 47-67 months) and 47%, respectively, in patients treated with resection and/or ablation only (p = 0.002). Adjuvant HAIP was associated with superior hDFS (adjusted HR 0.599, 95% CI 0.38-0.93, p = 0.02) and OS (adjusted HR 0.59, 95% CI 0.38-0.92, p = 0.02) in multivariable analysis.CONCLUSION: Adjuvant HAIP chemotherapy after resection and/or ablation of recurrent CRLM is associated with superior hDFS and OS.",

author = "Buisman, {Florian E} and Filipe, {Wills F} and Kemeny, {Nancy E} and Narayan, {Raja R} and Srouji, {Rami M} and Balachandran, {Vinod P} and Thomas Boerner and Drebin, {Jeffrey A} and Jarnagin, {William R} and Kingham, {T Peter} and Wei, {Alice C} and Gr{\"u}nhagen, {Dirk J} and Cornelis Verhoef and Koerkamp, {Bas Groot} and D'Angelica, {Michael I}",

note = "Publisher Copyright: {\textcopyright} 2020, The Author(s).",

year = "2021",

month = feb,

doi = "10.1245/s10434-020-08776-0",

language = "English",

volume = "28",

pages = "808--816",

journal = "Annals of Surgical Oncology",

issn = "1068-9265",

publisher = "Springer Science+Business Media",

number = "2",

}

Buisman, FE , Filipe, WF, Kemeny, NE, Narayan, RR, Srouji, RM, Balachandran, VP, Boerner, T, Drebin, JA, Jarnagin, WR, Kingham, TP, Wei, AC, Grünhagen, DJ , Verhoef, C , Koerkamp, BG & D'Angelica, MI 2021, 'Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy', Annals of Surgical Oncology, vol. 28, no. 2, pp. 808-816. https://doi.org/10.1245/s10434-020-08776-0

TY - JOUR

T1 - Recurrence After Liver Resection of Colorectal Liver Metastases

T2 - Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy

AU - Buisman, Florian E

AU - Filipe, Wills F

AU - Kemeny, Nancy E

AU - Narayan, Raja R

AU - Srouji, Rami M

AU - Balachandran, Vinod P

AU - Boerner, Thomas

AU - Drebin, Jeffrey A

AU - Jarnagin, William R

AU - Kingham, T Peter

AU - Wei, Alice C

AU - Grünhagen, Dirk J

AU - Verhoef, Cornelis

AU - Koerkamp, Bas Groot

AU - D'Angelica, Michael I

PY - 2021/2

Y1 - 2021/2

N2 - BACKGROUND: The aim of this study was to investigate the effectiveness of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after complete resection or ablation of recurrent colorectal liver metastases (CRLM).METHODS: A retrospective cohort study was conducted of patients from two centers who were treated with resection and/or ablation of recurrent CRLM only between 1992 and 2018. Overall survival (OS) and hepatic disease-free survival (hDFS) were estimated using the Kaplan-Meier method. The Cox regression method was used to calculate hazard ratios (HRs) with corresponding 95% confidence intervals (CI).RESULTS: Of 374 eligible patients, 81 (22%) were treated with adjuvant HAIP chemotherapy. The median follow-up for survivors was 65 months (IQR 32-118 months). Patients receiving adjuvant HAIP were more likely to have multifocal disease and receive perioperative systemic chemotherapy at time of resection for recurrence. A median hDFS of 46 months (95% CI 29-81 months) was found in patients treated with adjuvant HAIP compared with 18 months (95% CI 15-26 months) in patients treated with resection and/or ablation alone (p = 0.001). The median OS and 5-year OS were 89 months (95% CI 52-126 months) and 66%, respectively, in patients treated with adjuvant HAIP compared with 57 months (95% CI 47-67 months) and 47%, respectively, in patients treated with resection and/or ablation only (p = 0.002). Adjuvant HAIP was associated with superior hDFS (adjusted HR 0.599, 95% CI 0.38-0.93, p = 0.02) and OS (adjusted HR 0.59, 95% CI 0.38-0.92, p = 0.02) in multivariable analysis.CONCLUSION: Adjuvant HAIP chemotherapy after resection and/or ablation of recurrent CRLM is associated with superior hDFS and OS.

AB - BACKGROUND: The aim of this study was to investigate the effectiveness of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after complete resection or ablation of recurrent colorectal liver metastases (CRLM).METHODS: A retrospective cohort study was conducted of patients from two centers who were treated with resection and/or ablation of recurrent CRLM only between 1992 and 2018. Overall survival (OS) and hepatic disease-free survival (hDFS) were estimated using the Kaplan-Meier method. The Cox regression method was used to calculate hazard ratios (HRs) with corresponding 95% confidence intervals (CI).RESULTS: Of 374 eligible patients, 81 (22%) were treated with adjuvant HAIP chemotherapy. The median follow-up for survivors was 65 months (IQR 32-118 months). Patients receiving adjuvant HAIP were more likely to have multifocal disease and receive perioperative systemic chemotherapy at time of resection for recurrence. A median hDFS of 46 months (95% CI 29-81 months) was found in patients treated with adjuvant HAIP compared with 18 months (95% CI 15-26 months) in patients treated with resection and/or ablation alone (p = 0.001). The median OS and 5-year OS were 89 months (95% CI 52-126 months) and 66%, respectively, in patients treated with adjuvant HAIP compared with 57 months (95% CI 47-67 months) and 47%, respectively, in patients treated with resection and/or ablation only (p = 0.002). Adjuvant HAIP was associated with superior hDFS (adjusted HR 0.599, 95% CI 0.38-0.93, p = 0.02) and OS (adjusted HR 0.59, 95% CI 0.38-0.92, p = 0.02) in multivariable analysis.CONCLUSION: Adjuvant HAIP chemotherapy after resection and/or ablation of recurrent CRLM is associated with superior hDFS and OS.

UR - http://www.scopus.com/inward/record.url?scp=85087727723&partnerID=8YFLogxK

U2 - 10.1245/s10434-020-08776-0

DO - 10.1245/s10434-020-08776-0

M3 - Article

C2 - 32648182

SN - 1068-9265

VL - 28

SP - 808

EP - 816

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - 2

ER -

Recurrence After Liver Resection of Colorectal Liver Metastases: Repeat Resection or Ablation Followed by Hepatic Arterial Infusion Pump Chemotherapy

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