Published online Dec 7, 2017. doi: 10.3748/wjg.v23.i45.8027
Peer-review started: June 22, 2017
First decision: July 13, 2017
Revised: July 28, 2017
Accepted: September 6, 2017
Article in press: September 6, 2017
Published online: December 7, 2017
To analyze the homogeneity of pathologic response to preoperative chemotherapy (PRPC) after chemotherapy in patients with multiple liver metastases (LM).
From September 2011 to August 2014, patients with at least two LM undergoing preoperative chemotherapy prior to resection were included in this retrospective, single-center study. The endpoints were PRPC homogeneity (according to both the Rubbia-Brandt and MD Anderson classifications), the impact of PRPC on the MDT decision, factors associated with homogeneous PRPC and overall survival of patients with vs. without homogeneous PRPC.
seventy-three patients with a total of 88 liver resections (including 15 two-stage procedures) were included in the study. The homogeneous PRPC rate was 55% according to the Rubbia-Brandt classification and 53% according to the MD Anderson classification. The MDT decision was modified by the PRPC in only 2.7% of patients (n = 2).
The PRPC was homogeneous in only one half of patients and had very little influence on the MDT decision.
Core tip: Pathologic response to preoperative chemotherapy (PRPC) is correlated with survival after resection of liver metastases. This study analyzed the homogeneity of PRPC after chemotherapy in patients with multiple liver metastases. The study underlines that homogeneous PRPC rate was low (55% according to the Rubbia-Brandt classification and 53% according to the MD Anderson classification) and has little impact on the multidisciplinary team meeting decision (modified by the PRPC in only 2.7% of patients).