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Cited 6 time in webofscience Cited 6 time in scopus
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Oncologic and surgical outcomes in colorectal cancer patients with liver cirrhosis: A propensity-matched study

Authors
Han, Eon ChulRyoo, Seung-BumPark, Ji WonYi, Jin WookOh, Heung-KwonChoe, Eun KyungHa, Heon-KyunPark, Byung KwanMoon, Sang HuiJeong, Seung-YongPark, Kyu Joo
Issue Date
Jun-2017
Publisher
PUBLIC LIBRARY SCIENCE
Citation
PLOS ONE, v.12, no.6
Journal Title
PLOS ONE
Volume
12
Number
6
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/4338
DOI
10.1371/journal.pone.0178920
ISSN
1932-6203
Abstract
The management of colorectal cancer in patients with liver cirrhosis requires a thorough understanding of both diseases. This study evaluated the effect of liver cirrhosis on oncologic and surgical outcomes and prognostic factors in colorectal cancer patients. Fifty-five consecutive colorectal cancer patients with liver cirrhosis underwent colorectal resection (LC group). Using a prospectively maintained database, these patients were matched 1: 4 using propensity scoring with R programming language, package "MatchIt" and "optmatch" by sex, age, cancer location, and tumor stage with 220 patients without liver cirrhosis (non-LC group), resulting in 275 patients. The 5-year overall survival (OS) was significantly worse in the LC group than in the non-LC group (46.7% vs. 76.2% respectively, P < 0.001); however, the 5-year proportion of recurrence free (PRF) rates were similar (73.1% vs. 84.5% respectively, P = 0.094). On multivariate analysis of the LC group, tumor-node-metastasis (TNM) stage >= III disease, venous invasion, and a model for end-stage liver disease plus serum sodium (MELD-Na) score >10 were prognostic factors for OS. However, the OS was not different between the LC group with MELD-Na score <= 10 and the non-LC group (5-year OS rate, TNM stage <= II, 85.7 vs 89.5%, p = 0.356; TNM stage >= III, 41.1 vs 66.2%, p = 0.061). Colorectal cancer patients with liver cirrhosis have poorer OS compared to those without liver cirrhosis; however, the PRF rates are similar. It might be due to the mortality from the liver, and surgical treatment should be actively considered for patients with MELD-Na score <10.
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