Multidisciplinary discussion and management of synchronous colorectal liver metastases: A single center study in China

doi:10.4251/wjgo.v15.i9.1616

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Gastrointest Oncol. Sep 15, 2023; 15(9): 1616-1625
Published online Sep 15, 2023. doi: 10.4251/wjgo.v15.i9.1616

Table 1 Demographic and clinical characteristics of patients

Characteristics	MDT+ (n = 93)	MDT- (n = 169)	P value
Age (yr), mean (min-max)	59.19 (28.00-89.00)	60.15 (25.00-92.00)	0.605
Male/female, n	40/53	89/80	0.172
BMI (kg/m²), mean (min-max)	24.83 (17.29-33.82)	23.62 (16.06-33.5)	0.221
KPs score ≥ 60	89/12	150/19	0.095
Adenocarcinoma/mucinous adenocarcinoma, n	83/10	143/26	0.393
Poor differentiation, n (%)	16 (17.20)	21 (12.43)	0.380
Primary tumor category ≥ T3, n (%)	67 (72.04)	135 (79.88)	0.197
Primary LN involvement, n (%)	60 (64.52)	118 (69.82)	0.458
Multiple liver metastases, n (%)	75 (80.65)	134 (79.29)	0.920

BMI: Body mass index; KPs: Karnofsky performance status; LN: Lymph node; MDT: Multidisciplinary team.

Table 2 Baseline imaging examination and radiological tumor-node-metastasis staging

	MDT+ (n = 93)	MDT- (n = 169)	P value
Chest CT, n (%)	93 (100)	140 (82.84)	0.001
Abdomen MRI, n (%)	89 (95.70)	125 (73.96)	0.000
PET-CT, n (%)	22 (23.66)	47 (27.81)	0.906
TNM staging, n (%)	93 (100)	34 (20.12)	0.000

CT: Computed tomography; MRI: Magnetic resonance imaging; PET: Positron emission tomography; TNM: Tumor-node-metastasis; MDT: Multidisciplinary team.

Table 3 Oncology treatment and surgery

	MDT+ (n = 93)	MDT- (n = 169)	P value
Initial resectable, n (%)	17(18.285)	21 (12.43)	0.270
Successful conversion chemotherapy, n (uninitial resectable, n)	13 (76¹)	14 (148¹)	0.148
Chemotherapy, n (%)	77 (82.80)	116 (68.64)	0.019
Curative resection, n (%)	30 (32.29)	35 (20.71)	0.042
Simultaneous resection, n (%)	29 (97.63)	19 (55.88)	0.001
RFA, n (%)	5 (16.67)	15 (44.12)	0.036

¹Values in parentheses are numbers of patients with unresectable liver metastases.

RFA: Radiofrequency ablation; MDT: Multidisciplinary team.

Table 4 Univariate and multivariate analyses of risk factors associated with 1-year overall survival

	n (%)	Univariate			Multivariate
	n (%)	HR	95%CI	P value	HR	95%CI	P value
Age > 75	61 (23.28)	3.533	2.44-5.11	0.000	2.065	1.257-3.393	0.004
Sex (male)	133 (50.76)	0.845	0.590-1.211	0.358
BMI > 28	46 (17.56)	0.765	0.468-1.250	0.285
CEA > 5 ng/mL	125 (47.71)	7.296	4.674-11.391	0.000	5.308	3.262-8.638	0.000
Colon primary	118 (45.04)	1.283	0.896-1.838	0.174	1.058	0.724-1.544	0.772
Mucinous adenocarcinoma	36 (13.74)	0.863	0.502-1.482	0.593
Poor differentiation	37 (14.12)	1.282	0.793-2.073	0.311
Primary tumor category ≥ T3	202 (77.10)	1.284	0.820-2.009	0.274
Primary LN involvement	178 (67.94)	3.336	2.061-5.400	0.000	1.948	1.156-3.281	0.012
Multiple liver metastases	210 (80.15)	13.97	4.44-43.97	0.000	4.747	1.470-15.333	0.009
MDT	93 (35.50)	0.53	0.353-0.801	0.003	0.572	0.374-0.874	0.010
chemotherapy	193 (73.66)	0.239	0.166-0.344	0.000	0.874	0.539-1.418	0.587
Curative resection	67 (25.57)	0.016	0.002-0.114	0.000	0.031	0.004-0.227	0.001

HR: Hazards ratio; CI: Confidence interval; BMI: Body mass index; CEA: Carcinoembryonic antigen; MDT: Multidisciplinary team; LN: Lymph node.

Table 5 Univariate and multivariate analyses of risk factors associated with 5-year overall survival

	n (%)	Univariate			Multivariate
	n (%)	HR	95%CI	P value	HR	95%CI	P value
Age > 75	61 (23.28)	3.471	2.532-4.758	0.000	2.040	1.322-3.149	0.001
Sex (male)	133 (50.76)	0.938	0.721-1.221	0.938
BMI > 28	46 (17.56)	0.951	0.679-1.331	0.769
CEA > 5 ng/mL	125 (47.71)	2.446	1.872-3.195	0.000	2.516	1.847-3.428	0.000
Colon primary	118 (45.04)	1.349	1.035-1.757	0.027	0.828	0.622-1.102	0.195
Mucinous adenocarcinoma	36 (13.74)	0.792	0.529-1.184	0.256
Poor differentiation	37 (14.12)	1.102	0.758-1.603	0.611
Primary tumor category ≥ T3	202 (77.10)	0.969	0.710-1.322	0.841
Primary LN involvement	178 (67.94)	1.567	1.175-2.088	0.002	1.143	0.835-1.566	0.404
Multiple liver metastases	210 (80.15)	3.852	2.592-5.725	0.000	2.563	1.671-3.932	0.000
MDT	93 (35.50)	0.667	0.504-0.884	0.005	0.709	0.527-0.954	0.023
Chemotherapy	193 (73.66)	0.203	0.147-0.281	0.000	0.591	0.388-0.900	0.014
Curative resection	67 (25.57)	0.091	0.058-0.144	0.000	0.111	0.069-0.178	0.000

HR: Hazards ratio; CI: Confidence interval; BMI: Body mass index; CEA: Carcinoembryonic antigen; MDT: Multidisciplinary team; LN: Lymph node.

Citation: Li H, Gu GL, Li SY, Yan Y, Hu SD, Fu Z, Du XH. Multidisciplinary discussion and management of synchronous colorectal liver metastases: A single center study in China. World J Gastrointest Oncol 2023; 15(9): 1616-1625
URL: https://www.wjgnet.com/1948-5204/full/v15/i9/1616.htm
DOI: https://dx.doi.org/10.4251/wjgo.v15.i9.1616