Potential predictors of survival after surgery for colorectal cancer patients with synchronous unresectable liver metastases

Abstract Background There have been controversial voices on if hepatitis B virus infection decreases the risk of colorectal liver metastases or not. This study aims to the find the association between HBV infection and postoperative survival of colorectal cancer and the risk of liver metastases in colorectal cancer patients. Methods Patients who underwent curative surgical resection for colorectal cancer between January 2011 and December 2012 were included. Patients were grouped according to anti-HBc. Differences in overall survival, time to progress, and hepatic metastasis-free survival between groups and significant predictors were analyzed. Results Three hundred twenty-seven colorectal cancer patients were comprised of 202 anti-HBc negative cases and 125 anti-HBc positive cases, and anti-HBc positive cases were further divided into high-titer anti-HBc group (39) and low-titer anti-HBc group (86). The high-titer anti-HBc group had significantly worse overall survival (5-Yr, 65.45% vs. 80.06%; P < .001), time to progress (5-Yr, 44.26% vs. 84.73%; P < .001), and hepatic metastasis-free survival (5-Yr, 82.44% vs. 94.58%; P = .029) than the low-titer group. Multivariate model showed anti-HBc ≥ 8.8 S/CO was correlated with poor overall survival (HR, 3.510; 95% CI, 1.718–7.17; P < .001), time to progress (HR, 5.747; 95% CI, 2.789–11.842; P < .001), and hepatic metastasis-free survival (HR, 3.754; 95% CI, 1.054–13.369; P = .041) in the anti-HBc positive cases. Conclusions Higher titer anti-HBc predicts a potential higher risk of liver metastases and a worse survival in anti-HBc positive colorectal cancer patients.

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Chemotherapy and target therapy as neo-adjuvant approach for initially unresectable colorectal liver metastases

Oncology Reviews ◽

10.4081/oncol.2012.e6 ◽

2012 ◽

Vol 6 (1) ◽

pp. 6

Author(s):

Luigi Rossi ◽

Angelo Zullo ◽

Federica Zoratto ◽

Anselmo Papa ◽

Martina Strudel ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Cancer Patients ◽

Target Therapy ◽

Resection Rate ◽

Biological Drugs ◽

Unresectable Colorectal Liver Metastases ◽

Neo Adjuvant Chemotherapy ◽

Colorectal Cancer Patients

Although surgery is the most effective treatment for liver metastases in colorectal cancer patients, only 15-20% of these patients are suitable for a radical surgical approach, and metastases recurrence may occur at follow up. In the last decade, the use of pre-operative chemotherapy in combination with new biological drugs has been introduced. We reviewed data of neo-adjuvant chemotherapy strategies aimed at increasing the resection rate of liver metastases in colorectal cancer patients who were initially considered unresectable.

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Liver-First Approach in Treatment of Colorectal Cancer Patients with Synchronous Liver Metastases

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2019.11.181 ◽

2020 ◽

Vol 46 (2) ◽

pp. e79

Author(s):

Zaurbek Dudaev ◽

Viacheslav Aliev ◽

Zaman Mamedli ◽

Danil Podluzhny ◽

Islam Tataev ◽

...

Keyword(s):

Colorectal Cancer ◽

Liver Metastases ◽

Cancer Patients ◽

Synchronous Liver Metastases ◽

Colorectal Cancer Patients

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The Role of Big Endothelin-1 in Colorectal Cancer

The International Journal of Biological Markers ◽

10.1177/172460080201700407 ◽

2002 ◽

Vol 17 (4) ◽

pp. 268-274 ◽

Cited By ~ 5

Author(s):

C. Arun ◽

B. Swift ◽

K.E. Porter ◽

K.P. West ◽

N.J.M. London ◽

...

Keyword(s):

Colorectal Cancer ◽

Plasma Concentration ◽

Liver Metastases ◽

Cancer Cells ◽

Cancer Patients ◽

Hepatic Metastases ◽

Plasma Samples ◽

Median Score ◽

Endothelin 1 ◽

Colorectal Cancer Patients

Introduction Changes in liver blood flow caused by an unknown splanchnic vasoconstrictor have been noted in colorectal cancer patients with liver metastases. This prospective study was performed to assess whether plasma levels of big endothelin-1 (big ET-1) were raised in patients with colorectal cancer. Methods Plasma samples from peripheral vein of patients who underwent surgery for primary colorectal cancer (n=60) and those with known colorectal liver metastases (n=45) for a period of 15 months were taken prior to treatment and compared to age- and sex-matched controls (n=20). Plasma samples were analysed by using a single-step sandwich enzyme immunoassay. Immunohistochemistry and in situ hybridisation were also performed on tumour sections to investigate the expression of ET-1 by cancer cells. Results The median (range) plasma concentration of big ET-1 in controls was 2.1 pg/mL (1.2–13.4 pg/mL). The median (range) plasma concentration of big ET-1 in colorectal cancer patients with no overt hepatic metastases was 3.8 pg/mL (1.2–15.8 pg/mL), p=0.002, and the median (range) plasma concentration of big ET-1 in colorectal cancer patients with hepatic metastases was 5.2 pg/mL (1.7–30 pg/mL), p=0.0001; both were significantly elevated compared to the control group. A significant difference in immunostaining for big ET-1 was noted between paired normal colonic mucosa (median score-1) and tumour sections (median score-3), p=0.01. Conclusion This study has demonstrated elevated concentrations of big ET-1 in colorectal cancer patients, especially in those with hepatic metastases. Upregulation of ET activity in colorectal cancer could be inferred by the increased immunostaining of big ET-1 in cancer cells. Therefore, plasma big ET-1 levels should be evaluated as a potential tumour marker for the identification of hepatic metastases at an earlier stage.

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