Evolving survival gains in patients with young-onset colorectal cancer and synchronous resectable liver metastases
Menée auprès de 310 patients atteints d'un cancer colorectal de survenue précoce et présentant des métastases hépatiques synchrones (56 % d'hommes), cette étude analyse les caractéristiques et l'efficacité d'un traitement chirurgical
We aimed to evaluate the practice and the associated outcomes of surgical treatment for young-onset colorectal cancer (YOCRC) patients presenting with synchronous liver metastases. The study cohort was divided into two groups according to surgery date: 131 patients in the early era (EE, 1998?2011) and 179 in the contemporary era (CE, 2012?2020). The CE had a higher rate of node-positive primary tumors, higher carcinoembryonic antigen level, and lower rate of RAS/BRAF mutations. The CE had higher rates of reverse or combined resection, multi-drug prehepatectomy chemotherapy, and two-stage hepatectomy. The median survival was 8.4 years in the CE and 4.3 years in the EE (p?=?0.011). On multivariate analysis, hepatectomy in the CE was independently associated with improved overall survival (HR 0.48, p?=?0.001). With a combination of perioperative systemic therapy, careful selection of treatment approach, and coordinated resections, durable cure can be achieved in YOCRC patients.