Survival of patients with initially unresectable colorectal liver metastases treated with FOLFOX/cetuximab or FOLFIRI/cetuximab in a multidisciplinary concept (CELIM study)

Folprecht, Gunnar; Gruenberger, Thomas; Bechstein, Wolf O.; Raab, Hans-Rudolf; Weitz, Jürgen; Lordick, Florian; Hartmann, Jörg T.; Stoehlmacher-Williams, Jan; Lang, Hauke; Trarbach, Tanja; Liersch, Torsten; Ockert, D.; Jaeger, Dirk; Steger, Ulrich; Suedhoff, Thomas; Rentsch, Anke; Köhne, Claus‐Henning

doi:10.1093/annonc/mdu088

Cited by 223 publications

(134 citation statements)

References 21 publications

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“…Liver metastasis of gastric cancer is defined as stage IVb disease, for which systemic therapy is recommended [6,7]. By contrast, colorectal liver metastases are widely considered as targets of surgery with an intent to cure because they often present as liver-only diseases, and R0 resection showed favorable survival in a recent clinical study [8]. Recently, the Guidelines Committee of the Japan Gastric Cancer Association reconsidered the treatment of potentially resectable M1 disease [9], on the basis of a report that showed favorable results in resectable liver metastases [10][11][12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

et al. 2015

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Background The necessity of surgical treatment of liver metastases of gastric cancer is still controversial. Patients and methods We conducted a multicenter retrospective cohort study of liver-limited metastasis of gastric cancer treated surgically between 2000 and 2010. In this study, 103 patients were registered, with nine patients excluded from the analysis as they did not meet the eligibility criteria.Results Of the 94 patients, 69 underwent surgical resection, 11 underwent surgical resection combined with radiofrequency ablation or microwave coagulation therapy for small or deep tumors, and 14 underwent radiofrequency ablation or microwave coagulation therapy only. Synchronous and metachronous metastases were found in 37 and 57 patients, respectively. The 3-and 5-year overall survival rates of all the patients were 51.4 and 42.3 %, respectively. The 3-and 5-year relapse-free survival rates were 29.2 and 27.7 %, respectively. No significant difference in prognosis was observed between the patients who underwent surgical resection and those who underwent ablation therapy. The patients with hepatic solitary lesions and low-grade lymph node metastases of primary gastric cancer had significantly better overall survival and relapsefree survival. Conclusions To our knowledge, this study is the largest series and first multicenter cohort study of liver-limited metastasis of gastric cancer. The study indicated that patients with a single liver metastasis with a grade lower than N2 lymph node metastasis of the primary lesion are the best candidates for liver resection.

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Section: Introductionmentioning

confidence: 99%

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

et al. 2015

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“…Thus, the general consensus is that patients with K-Ras mutations do not benefit from cetuximab treatment. Patients with wild-type K-Ras, in contrast to the mutant type, may even benefit from cetuximab dose escalation and the overall survival time is twice as long in K-Ras wild-type patients treated with cetuximab compared with patients harboring K-Ras mutations (26)(27)(28)(29)(30)(31)(32). In addition to extensive studies on the role of the K-Ras mutation status in determining the response to cetuximab in colon cancer patients, the same phenomenon has been observed in several other types of cancer, including advanced rectal cancer, gastric cancer, inoperable biliary tract cancer and squamous cell carcinoma of the skin (33)(34)(35)(36).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of K-Ras mutations in hepatocellular carcinoma: A Turkish Oncology Group pilot study

Turhal

Savaş

Çoşkun

et al. 2015

Molecular and Clinical Oncology

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Abstract. Hepatocellular carcinoma (HCC) is the fifth most common male-predominant type of cancer worldwide. There is no effective treatment regimen available for advanced-stage disease and chemotherapy is generally ineffective in these patients. The number of studies on the prevalence of K-Ras mutations in HCC patients is currently limited. A total of 58 patients from 6 comprehensive cancer centers in 4 metropolitan cities of Turkey were enrolled in this study. Each center committed to enroll approximately 10 random patients whose formalin-fixed paraffin-embedded tumor tissues were available for K-Ras, exon 2 genotyping. Two methods were applied based on the availability of adequate amounts of tumor DNA. In the first method, the samples were processed using TheraScreen. The genomic DNA was further used to detect the 7 most frequent somatic mutations (35G>A; 35G>C; 35G>T; 34G>A; 34G>C; 34G>T and 38G>A) in codons 12 and 13 in exon 2 of the K-Ras oncogene by quantitative polymerase chain reaction (PCR). In the second method, the genomic DNA was amplified by PCR using primers specific for K-Ras exon 2 with the GML SeqFinder Sequencing System's KRAS kit. The identified DNA sequence alterations were confirmed by sequencing both DNA strands in two independent experiments with forward and reverse primers. A total of 40 samples had adequate tumor tissue for the mutation analysis. A total of 33 (82.5%) of the investigated samples harbored no mutations in exon 2. All the mutations were identified via a direct sequencing technique, whereas none were identified by TheraScreen. In conclusion, in our patients, HCC exhibited a remarkably low (<20%) K-Ras mutation rate. Patients harboring K-Ras wild-type tumors may be good candidates for treatment with epidermal growth factor inhibitors, such as cetuximab.

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“…Colorectal liver metastases are widely considered targets of surgery with curative intent because they often present as liver-only diseases, and R0 resection showed favorable survival in a recent clinical study [11] . However, the necessity of surgical resection of liver metastases of gastric cancer is still controversial.…”

Section: Liver Metastasesmentioning

confidence: 99%

Conversion surgery for stage IV gastric cancer

Ida¹,

Watanabe²

2018

JCMT

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Gastric cancer with distant metastases, such as para-aortic lymph node metastases, hepatic metastases, and peritoneal dissemination, is classified as stage IV. In this situation, cancer cells have formed micrometastases throughout the body; therefore, according to the algorithm of the Japanese guidelines, stage IV cancer is outside the indication for curative resection. Recent advances in some chemical agents have been remarkable, and some patients have survived for long periods even with stage IV gastric cancer. Thus, even in patients with stage IV gastric cancer, there is a possibility that gastrectomy as conversion surgery could play an important role in the treatment strategy. Gastrectomy as conversion therapy can be safely conducted without perioperative mortality and is considered a sufficiently acceptable treatment strategy. However, the significance of conversion surgery for stage IV gastric cancer remains controversial. In this review, we summarize the treatment strategies and outcomes of conversion surgery for stage IV gastric cancer.

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Survival of patients with initially unresectable colorectal liver metastases treated with FOLFOX/cetuximab or FOLFIRI/cetuximab in a multidisciplinary concept (CELIM study)

Abstract: NCT00153998, www.clinicaltrials.gov.

Cited by 223 publications

References 21 publications

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

Surgical treatment of liver metastasis of gastric cancer: a retrospective multicenter cohort study (KSCC1302)

Prevalence of K-Ras mutations in hepatocellular carcinoma: A Turkish Oncology Group pilot study

Conversion surgery for stage IV gastric cancer

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