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Short-term Outcomes After Upfront Chemotherapy Followed by Curative Surgery in Metastatic Colon Cancer: A Comparison With Upfront Surgery Patients

Annals of Coloproctology 2019년 35권 6호 p.327 ~ 334
Han Myung-Hyun, 박윤영, Pratap Shiva, 한윤대, 조민수, Hur Hyuk, 민병소, 이강용, 김남규,
소속 상세정보
 ( Han Myung-Hyun ) - Yonsei University College of Medicine Department of Surgery
박윤영 ( Park Youn-Young ) - Catholic University College of Medicine Uijeongbu St. Mary’s Hospital Department of Surgery
 ( Pratap Shiva ) - Christian Medical College and Hospital Department of Surgery
한윤대 ( Han Yoon-Dae ) - Yonsei University College of Medicine Severance Hospital Department of Surgery
조민수 ( Cho Min-Soo ) - Yonsei University College of Medicine Department of Surgery
 ( Hur Hyuk ) - Yonsei University College of Medicine Department of Surgery
민병소 ( Min Byung-Soh ) - Yonsei University College of Medicine Department of Surgery
이강용 ( Lee Kang-Young ) - Yonsei University College of Medicine Department of Surgery
김남규 ( Kim Nam-Kyu ) - Yonsei University College of Medicine Department of Surgery

Abstract


Purpose: Upfront systemic chemotherapy with target agents has been recommended for patients with stage IV colon cancer. Some with partial response are considered for curative resection. There is high risk of developing postoperative complications following upfront systemic chemotherapy. We aimed to evaluate short-term perioperative outcomes of curative surgery after upfront chemotherapy in comparison with upfront surgery in patients with metastatic colon cancer.

Methods: Between January 2010 and October 2015, 146 patients (80 in the surgery first group, 66 in the upfront chemotherapy group) who underwent surgical resection before or after systemic chemotherapy for metastatic colon cancer were included in the present study. All decisions for treatment were made through a multidisciplinary team. Postoperative clinical outcomes and complications were analyzed to compare the groups.

Results: There was no difference between the 2 groups in terms of postoperative clinical outcomes. Overall complication rates were not different between the groups (surgery first group: 46.3% vs. upfront chemotherapy group: 60.6%; P = 0.084). When classified according to the Clavien-Dindo method, there was no difference between the 2 groups in terms of major complications (grade 3 or more) (surgery first group: 18.9% vs. upfront chemotherapy group: 27.5%; P = 0.374).

Conclusion: There was no significant increase in major postoperative complications in metastatic colon cancer patients who received upfront chemotherapy followed by curative surgery. Careful patient selection and treatment planning are important.

키워드

Colonic neoplasms; Neoplasm metastasis; Antineoplastic agents; Postoperative complications

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