CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Rozhl. Chir., 2006, roč. 85, č. 3, s. 124–128. |
Prediction of Treatment
Outcome after Adjuvant Loco-regional Chemotherapy Following Liver Resection for
Colorectal Metastases – Preliminary Results Strnad R., Ryska M., Bělina F., Langer D., *Novotný J., **Ludvíková M. Chirurgická klinika 2. LF UK a ÚVN Praha, přednosta prof. MUDr. M. Ryska, CSc. *Klinika onkologie Všeobecné fakultní nemocnice Praha, přednosta doc. MUDr. L. Petruželka, CSc. **Šiklův patologicko-anatomický ústav FN Plzeň, přednosta prof. MUDr. M. Michal, CSc. |
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Summary: Introduction and aim of study: Czech Republic leads the worldwide league in colorectal cancer’s occurrence. Colorectal
liver metastases are detected in about a half of patients with colorectal cancer. Liver resection of colorectal metastases is
currently the only potentially curative treatment with a chance for a long-term survival rate. Until now there has remained
a question of whether adjuvant HAIC can improve the treatment results of radical resection. The aim of our study is to verify
predictive efficiency of thymidylátsyntasis (TS), dihydropyrimidindehydrogenasis (DPD) and thymidinfosforylasis (TP)
in patients undergoing adjuvant hepatic artery infusion chemotherapy (HAIC) following radical liver resection for colorectal
metastases.
Methods: From 1990 to 2005 80 patients underwent 84 liver resections for colorectal metastases. R0 resection was achieved
in 60 events. Ten patients who underwent R0 resection both for primary cancer and for colorectal liver metastases and who were
given portcatheter for HAIC were included in this study. Adjuvant chemotherapy contained 5-fluorourycil (1200 mg/m2) combined
with oxyliplatinum and leukovorin. Whole dose was administered via hepatic artery. The samples were procured both from
healthy liver tissue and from metastases for imunohistochemical and molecular biological analysis.
Results: The recurrence of disease was verified in 2 of 10 included patients (20%). We detected neither occurrence of death nor serious complication in early postoperative course in none of ten patients. Low expression of TS was found in both events
and very high expression of DPD in one event was detected.
Discussion: High expression of DPD in one of these patients could contribute to lower outcome of adjuvant chemotherapy.
Low expression of TS in both patients responds to the written statement regarding contribution of adjuvant chemotherapy
only in patients with high TS level.
Conclusion: The expression of TS and DPD responds to expected outcome of HAIC. Low number of patient does not permit
statistic evaluation.
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