Background

The objective was to investigate the impact of adjuvant hepatic arterial infusion pump (HAIP) chemotherapy on the rates and patterns of recurrence and survival in patients with resected colorectal liver metastases (CRLM).

Methods

Recurrence rates, patterns, and survival were compared between patients treated with and without adjuvant HAIP using competing risk analyses.

Results

2128 patients were included, of which 601 patients (28.2%) received adjuvant HAIP and systemic chemotherapy (HAIP + SYS). The overall recurrence rate was similar with HAIP + SYS or SYS (63.5% versus 64.2%,p = 0.74). The 5-year cumulative incidence of initial intrahepatic recurrences was lower with HAIP + SYS (22.9% versus 38.4%,p < 0.001). The 5-year cumulative incidence of initial extrahepatic recurrences was higher with HAIP + SYS (48.5% versus 40.3%,p = 0.005), because patients remained at risk for extrahepatic recurrence in the absence of intrahepatic recurrence, which was largely attributable to more pulmonary recurrences with HAIP + SYS (33.6% versus 23.7%,p < 0.001). HAIP was an independent prognostic factor for DFS (adjusted HR 0.69, 95% CI 0.60–0.79, p < 0.001), and OS (adjusted HR 0.67, 95% CI 0.57–0.78,p < 0.001).

Conclusion

Adjuvant HAIP chemotherapy is associated with lower intrahepatic recurrence rates and better DFS and OS after resection of CRLM.

中文翻译：

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肝动脉灌注泵化疗对切除的结直肠肝转移患者肝脏复发和生存率的影响。

背景

目的是研究辅助肝动脉输液泵 (HAIP) 化疗对切除的结直肠肝转移 (CRLM) 患者的复发率和生存率以及复发率和生存率的影响。

方法

使用竞争风险分析比较接受和不接受辅助 HAIP 治疗的患者的复发率、模式和生存率。

结果

共纳入2128例患者，其中601例（28.2%）接受了辅助HAIP和全身化疗（HAIP+SYS）。总体复发率与 HAIP + SYS 或 SYS 相似（63.5% 对 64.2%，p = 0.74）。HAIP + SYS 的 5 年初始肝内复发累积发生率较低（22.9% 对 38.4%，p < 0.001）。HAIP + SYS 的初始肝外复发的 5 年累积发生率更高（48.5% 对 40.3%，p = 0.005），因为在没有肝内复发的情况下，患者仍然有肝外复发的风险，这主要归因于更多的肺HAIP + SYS 的复发率（33.6% 对 23.7%，p < 0.001）。HAIP 是 DFS（调整后 HR 0.69，95% CI 0.60-0.79，p < 0.001）和 OS（调整后 HR 0.67，95% CI 0.57-0.78，p < 0.001）的独立预后因素。

结论

辅助HAIP化疗与CRLM切除后较低的肝内复发率和较好的DFS和OS相关。