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Significance of poor performance status after resection of colorectal liver metastases

Strandberg Holka, Peter LU ; Eriksson, Sam LU ; Eberhard, Jakob LU ; Bergenfeldt, Magnus LU ; Lindell, Gert LU and Sturesson, Christian LU (2018) In World Journal of Surgical Oncology 16(1).
Abstract

BACKGROUND: Performance status (PS) is known as one of the strongest prognostic factors for survival in metastatic colorectal cancer patients. The aim of the present study was to analyze factors associated with poor PS assessed after resection for colorectal liver metastases and the impact on survival.

METHODS: All patients undergoing curative resection for colorectal liver metastases between 2010 and 2015 in a single center were reviewed retrospectively.

RESULTS: A total of 284 patients were included, out of whom 74 patients (26%) presented with a postoperative PS WHO > 2 precluding administration of adjuvant chemotherapy. These patients had a shorter recurrence-free survival (P = 0.002) and shorter overall survival (P... (More)

BACKGROUND: Performance status (PS) is known as one of the strongest prognostic factors for survival in metastatic colorectal cancer patients. The aim of the present study was to analyze factors associated with poor PS assessed after resection for colorectal liver metastases and the impact on survival.

METHODS: All patients undergoing curative resection for colorectal liver metastases between 2010 and 2015 in a single center were reviewed retrospectively.

RESULTS: A total of 284 patients were included, out of whom 74 patients (26%) presented with a postoperative PS WHO > 2 precluding administration of adjuvant chemotherapy. These patients had a shorter recurrence-free survival (P = 0.002) and shorter overall survival (P < 0.001). Multivariable analysis showed that patients with PS > 2 after surgery had higher preoperative ASA score, had a higher frequency of major complications after surgery, and had more frequently synchronous liver and lung metastases. PS was found to be the strongest independent factor predicting survival (hazard ratio 0.45). When patients with postoperative PS > 2 developed recurrent disease (54 of 74), 43 (80%) received tumor specific treatment.

CONCLUSIONS: Patients with postoperative PS > 2 who did not receive adjuvant chemotherapy had decreased recurrence-free and overall survival after liver resection for colorectal liver metastases. After recurrence, a large majority of these patients had had improvement in PS allowing for administration of tumor specific treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Colorectal neoplasms, Hepatectomy
in
World Journal of Surgical Oncology
volume
16
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85051374052
ISSN
1477-7819
DOI
10.1186/s12957-017-1306-1
language
English
LU publication?
yes
id
f575a816-2fff-4a7f-b65e-090216c4843e
date added to LUP
2018-09-12 08:50:44
date last changed
2019-01-06 14:04:24
@article{f575a816-2fff-4a7f-b65e-090216c4843e,
  abstract     = {<p>BACKGROUND: Performance status (PS) is known as one of the strongest prognostic factors for survival in metastatic colorectal cancer patients. The aim of the present study was to analyze factors associated with poor PS assessed after resection for colorectal liver metastases and the impact on survival.</p><p>METHODS: All patients undergoing curative resection for colorectal liver metastases between 2010 and 2015 in a single center were reviewed retrospectively.</p><p>RESULTS: A total of 284 patients were included, out of whom 74 patients (26%) presented with a postoperative PS WHO &gt; 2 precluding administration of adjuvant chemotherapy. These patients had a shorter recurrence-free survival (P = 0.002) and shorter overall survival (P &lt; 0.001). Multivariable analysis showed that patients with PS &gt; 2 after surgery had higher preoperative ASA score, had a higher frequency of major complications after surgery, and had more frequently synchronous liver and lung metastases. PS was found to be the strongest independent factor predicting survival (hazard ratio 0.45). When patients with postoperative PS &gt; 2 developed recurrent disease (54 of 74), 43 (80%) received tumor specific treatment.</p><p>CONCLUSIONS: Patients with postoperative PS &gt; 2 who did not receive adjuvant chemotherapy had decreased recurrence-free and overall survival after liver resection for colorectal liver metastases. After recurrence, a large majority of these patients had had improvement in PS allowing for administration of tumor specific treatment.</p>},
  articleno    = {3},
  author       = {Strandberg Holka, Peter and Eriksson, Sam and Eberhard, Jakob and Bergenfeldt, Magnus and Lindell, Gert and Sturesson, Christian},
  issn         = {1477-7819},
  keyword      = {Colorectal neoplasms,Hepatectomy},
  language     = {eng},
  month        = {01},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {World Journal of Surgical Oncology},
  title        = {Significance of poor performance status after resection of colorectal liver metastases},
  url          = {http://dx.doi.org/10.1186/s12957-017-1306-1},
  volume       = {16},
  year         = {2018},
}