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Keywords:
Abdomen, Liver, Ultrasound, Intraoperative, Metastases
Authors:
M. J. van Amerongen1, J. J. Futterer1, S. F. M. Jenniskens1, H. de Wilt1, E. van der Stok2, D. J. Grünhagen2, C. Verhoef2, A. Moelker2; 1Nijmegen/NL, 2Rotterdam/NL
DOI:
10.1594/ecr2015/C-1318
Results
The combination group consisted of 98 patients,
while 534 patients were included in the only surgery group.
There was no significant difference between the two groups with regard to gender (P=0.99),
age (P=0.42),
BMI (P=0.53),
location of primary tumor (P=0.80) or the maximal size of metastasis (P=0.24).
Significantly different patient characteristics were a better ASA classification for the combination group due to more patients treated with ASA II (P=0.04).
However,
no difference was found in total comorbidities of patients (P=0.91).
Patients in the combination group had a higher total number of metastases (P=0.001),
had more frequently a high risk oncologic profile (Fong clinical risk score (CRS) 3-5; P=0.001) and had received more neoadjuvant chemotherapy (P=0.001).
These characteristics are summarized in Table 1.
There were no differences in postoperative complications or duration of hospital stay between the two groups.
In specific,
no differences in occurrence of intra-abdominal abscesses or other infections.
Although,
the patients in the combination group received more resections with a smaller resection margin and more R1 resections.
These results are summarized in Table 2.
After the first recurrence,
there was no difference in the amount of curative treatment between the two groups (P=0.33).
However,
after the second recurrence,
the combination group received significantly less curative treatment as compared to the patients who received only surgery (P=0.049).
The 5 year DFS of the combination group was 25% as compared to 36.1% (P=0.03) of the resection group.
While the 5 year OS was respectively 42% and 62.2% (P=0.001).
Survival curves are depicted in Fig 1.
Multivariate analysis showed that for the DFS the Fong CRS was a significant predictor,
while for the OS this were the ASA classification,
the Fong CRS and the combination itself.
Results of the multivariate analysis is shown in Table 3.