Discrepancy Between Recurrence-Free Survival and Overall Survival in Patients with Resectable Colorectal Liver Metastases: A Potential Surrogate Endpoint for Time to Surgical Failure
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- 作者：Masaru Oba MD ; PhD (1)
Kiyoshi Hasegawa MD ; PhD (1)
Yutaka Matsuyama PhD (2)
Junichi Shindoh MD ; PhD (1)
Yoshihiro Mise MD ; PhD (1)
Taku Aoki MD ; PhD (1)
Yoshihiro Sakamoto MD ; PhD (1)
Yasuhiko Sugawara MD ; PhD (1)
Masatoshi Makuuchi MD ; PhD (3)
Norihiro Kokudo MD ; PhD (1) - 刊名：Annals of Surgical Oncology
- 出版年：2014
- 出版时间：June 2014
- 年：2014
- 卷：21
- 期：6
- 页码：1817-1824
- 全文大小：
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Kiyoshi Hasegawa MD, PhD (1)
Yutaka Matsuyama PhD (2)
Junichi Shindoh MD, PhD (1)
Yoshihiro Mise MD, PhD (1)
Taku Aoki MD, PhD (1)
Yoshihiro Sakamoto MD, PhD (1)
Yasuhiko Sugawara MD, PhD (1)
Masatoshi Makuuchi MD, PhD (3)
Norihiro Kokudo MD, PhD (1)
1. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
2. Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
3. Department of Hepato-Biliary-Pancreatic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan - ISSN：1534-4681
文摘
Background Recurrence-free survival (RFS) may not be a surrogate for overall survival (OS) in patients with resectable colorectal liver metastases (CLM). We investigated whether a new composite tool—time to surgical failure (TSF)—is a suitable endpoint. Methods The medical records of consecutive patients who underwent curative resection for CLM at our center over a 17-year period were reviewed. Patients with liver-limited tumors (n?=?371) who had not received previous treatment for metastasis were eligible for analysis. TSF was defined as the time until unresectable relapse or death. The correlations between TSF and OS, and between RFS and OS, were assessed for all the eligible patients. Results The median OS, TSF, and RFS were 5.7, 2.7, and 0.7?years, respectively, and the 5-year OS, TSF, and RFS rates were 52.6, 39.8, and 23.7?%, respectively, for all patients. The rates of first, second, and third relapse were 75.5, 77.6, and 70.8?%, respectively, and repeat resections were performed in 54.3?% (first relapses), 40.7?% (second relapses), and 47.1?% (third relapses) of patients. The concordance proportions of TSF and RFS for OS events were 0.83 and 0.65, respectively. The correlation between TSF and OS was stronger than that between RFS and OS in terms of the predicted probabilities. Conclusions The correlation between TSF and OS was stronger than that between RFS and OS after curative hepatic resection. TSF could be a suitable endpoint for CLM overall management.