Relationship between survival outcomes in patients with colorectal liver metastasis undergoing hepatectomy and significance of fibrotic markers for liver injury assessment.

IF 1.7 4区 医学 Q4 ONCOLOGY Translational cancer research Pub Date : 2025-01-31 Epub Date: 2025-01-23 DOI:10.21037/tcr-24-1138
Atsushi Nanashima, Masahide Hiyoshi, Naoya Imamura, Takeomi Hamada, Yuki Tsuchimochi, Ikko Shimizu, Takahiro Ochiai, Akiko Ichihara, Kiyoaki Hamada, Nobuhiko Ichiki, Kengo Kai, Kazuhiro Higuchi
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Abstract

Background: Progression of chronic liver dysfunction influenced by long-term chemotherapy or repeated hepatectomy might be related to patient overall survival as well as tumor factors in colorectal liver metastasis (CLM) patients. Our aim of this study was to clarify the relationship between fibrotic liver damage and malignant behaviors of CLM malignancy or its long-term survivals by the retrospective cohort study.

Methods: We examined the relationship between tumor-related factors or six liver fibrosis-associated parameters, including platelet count, hyaluronic acid (HA), mac-2 binding protein glycosylation isomer (M2BPGi), type IV collagen 7S (T4C7), aspartate aminotransferase-to-platelet ratio index (APRI), The fibrosis-4 (Fib-4) index, and clinicopathological parameters, surgical records, and postoperative patient survival in the 45 consecutive patients with CLM who underwent radical hepatectomy.

Results: Fibrotic parameters were platelet count of 23.0±8.5 ×104/µL, HA level of 68.9±82.3 ng/mL, M2BPGi of 0.87±0.48 ng/mL, and type IV collagen level of 5.74±3.76 ng/mL. Platelet count was significantly correlated with HA level (P<0.05) and tended to be correlated with M2BPGi levels (P=0.056). HA level was significantly associated with albumin level (P<0.05). Overall survival in this series showed five-year overall survivors after hepatectomy in 44 patients (98%), but cancer-related deaths were observed in only one patient. Patients with higher grades and increased bilirubin levels demonstrated significantly lower cancer-free survival (P<0.05), but fibrotic parameters were not associated with prognostic factors.

Conclusions: Fibrotic markers indicating chemotherapy or repeated surgical liver injury were not significant predictive factors reflecting cancer malignant behaviors or patient overall survival, contrary to our hypothesis. The current overall survival status using various modalities for cancer recurrence is satisfactory under our present perioperative management.

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结直肠癌肝转移患者行肝切除术后生存结局与纤维化标志物在肝损伤评估中的意义
背景:结直肠癌肝转移(CLM)患者长期化疗或反复肝切除术影响慢性肝功能障碍的进展可能与患者总生存期及肿瘤因子有关。本研究的目的是通过回顾性队列研究,阐明肝纤维化损害与CLM恶性行为或其长期生存的关系。方法:我们对连续45例行根治肝切除术的CLM患者进行肿瘤相关因素与6项肝纤维化相关参数的关系,包括血小板计数、透明质酸(HA)、mac-2结合蛋白糖基化异构体(M2BPGi)、IV型胶原7S (T4C7)、天冬氨酸转氨酶与血小板比值指数(APRI)、纤维化-4 (Fib-4)指数,以及临床病理参数、手术记录和术后患者生存率。结果:纤维化指标为血小板计数23.0±8.5 ×104/µL, HA水平68.9±82.3 ng/mL, M2BPGi水平0.87±0.48 ng/mL, IV型胶原水平5.74±3.76 ng/mL。血小板计数与HA水平显著相关(p结论:表明化疗或反复手术肝损伤的纤维化标志物不是反映肿瘤恶性行为或患者总体生存的显著预测因素,与我们的假设相反。在我们目前的围手术期管理下,目前使用各种方式治疗癌症复发的总体生存状况是令人满意的。
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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
252
期刊介绍: Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.
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