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dc.creatorQuesada Soto, Paula
dc.creatorLandaverde Recinos, Denis
dc.creatorRamos Esquivel, Allan Eduardo
dc.date.accessioned2018-06-07T14:40:52Z
dc.date.available2018-06-07T14:40:52Z
dc.date.issued2017-02
dc.identifier.citationhttp://ascopubs.org/doi/full/10.1200/JGO.2016.003285es_ES
dc.identifier.issn2378-9506
dc.identifier.urihttp://hdl.handle.net/10669/74858
dc.description.abstractBackground Resection of liver-isolated metastases of colorectal cancer (CRC) offers the greatest likelihood of cure. Nevertheless, recurrence rates after this procedure are high, and chemotherapy is a reasonable choice with inconclusive evidence. We aimed to determine if there is a survival difference between patients receiving systemic therapy with surgery versus surgery alone for resection of liver metastases. Methods From a source population of 170 patients treated in our National Centre (Centro Nacional de Cirugía Hepatobiliar, San José, Costa Rica), with liver metastases from various primary sites, we selected 51 patients with CRC who underwent hepatic resection with curative intent. We categorized patients according to the treatment received (fluoropyrimidine-based chemotherapy plus or minus monoclonal antibody and surgery v surgery alone) and then calculated the overall survival (OS) rate according to the Kaplan-Meier method. A Cox proportional hazard model was used to assess the influence of potential confounding variables on OS. Results After a median follow-up of 41.6 months, OS was significantly better for patients treated with systemic therapy (before and/or after hepatic resection) versus surgery alone (3-year OS: 66.7% v 41.7%; hazard ratio, 0.37; 95% CI, 0.15 to 0.91; log-rank test: P = .025). There were no differences among patients who underwent neoadjuvant (48.7%), perioperative (46.2%), and adjuvant therapy (5.1%). The use of systemic therapy was significantly associated with better OS after adjustment for confounding variables (hazard ratio, 0.23; 95% CI, 0.07 to 0.92; P = .03). Conclusion Our findings support the use of systemic therapy (either perioperative, neoadjuvant, or adjuvant) as part of isolated hepatic metastasectomy from CRC.es_ES
dc.language.isoen_USes_ES
dc.rightsCC0 1.0 Universal*
dc.rights.urihttp://creativecommons.org/publicdomain/zero/1.0/*
dc.sourceJournal of Global Oncology, Vol. 3(1), 2017es_ES
dc.subjectLiver metastasises_ES
dc.subjectChemotherapyes_ES
dc.subjectCosta Ricaes_ES
dc.subject571.978 Tumoreses_ES
dc.titleLiver Metastasectomy and Systemic Therapy Improve Overall Survival Compared With Surgery Alone After Curative Liver Resection of Colorectal Metastases in a Developing Country (Costa Rica)es_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.typeArtículo científicoes_ES
dc.identifier.doi10.1200/JGO.2016.003285
dc.description.procedenceUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicinaes_ES
dc.identifier.pmid28717739
dc.identifier.pmidPMC5493235


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CC0 1.0 Universal
Except where otherwise noted, this item's license is described as CC0 1.0 Universal