Analyses of the relevance between microscopic cancer spread of colorectal liver metastases and perioperative chemotherapy

2016 Fiscal Year Final Research Report

• Project/Area Number: 26462038
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: The University of Tokyo
• Principal Investigator: Hasegawa Kiyoshi 東京大学, 医学部附属病院, 准教授 (20292906)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: 大腸癌肝転移 / 周術期化学療法 / 分子標的治療薬 / 微小転移 / 形態学的腫瘍変化

Outline of Final Research Achievements

Micrometastases exists around 20% of colorectal liver metastases (CLM), and preoperative chemotherapy for CLM reduces its frequency. Biologic agents, both anti-VEGF and anti-EGFR antibody, are associated with a decrease in the incidence of microscopic cancer spread beyond a width of 1 mm from the main lesion. Furthermore, in predicting the frequency and distribution of micrometastases around CLM the morphologic change in preoperative computed tomography is more favorable than the traditional tumor size-based criteria.
In patients with suboptimal morphologic response to preoperative chemotherapy for CLM, taking surgical margin more than 1mm prolongs surgical outcome. However, patients with optimal morphologic response show very good prognosis regardless of whether surgical margin is over 1mm or not, and the current study suggested the hepatic surgery with histological positive surgical margin can be acceptable, where necessary, in those patients with marginally resectable disease.

Free Research Field

消化器外科学、肝臓外科学