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Hepatogastroenterology. 2009 May-Jun;56(91-92):829-34.

Neoadjuvant chemotherapy followed by hepatectomy for primarily resectable colorectal cancer liver metastases.

Author information

  • 1Department of General Surgery, European Institute of Oncology, Milano, Italy. antonio.chiappa@unimi.it

Abstract

BACKGROUND/AIMS:

Hepatic resection in metastatic disease from colorectal cancer offers the best chance in selected cases for long-term survival. Neoadjuvant chemotherapy (NACT) has been advocated in some cases initially deemed irresectable with few reports of the efficacy of such a strategy and the influence of the response to chemotherapy on the outcome of radical hepatic resection.

METHODOLOGY:

Between December 1995 and May 2005, 88 patients with colorectal liver metastases underwent hepatic resection with curative intent. Twenty-five of these patients, (7 males, 18 females, mean age: 58+/-9 years; range: 40-75 years) deemed as resectable cases at the time of diagnosis were treated with neoadjuvant chemotherapy. A 7-year survival analysis was performed. Chemotherapy included mainly oxaliplatin or irinotecan containing regimens for a median of 6 courses.

RESULTS:

Fifteen patients (60%) had synchronous and 10 (40%) metachronous metastases. During preoperative chemotherapy tumor regression occurred in 8 cases (32%); stable disease (SD) in a further 10 patients (40%) and progressive disease (PD) developed in 7 cases (28%). The 5-year overall survival for NACT responders was 71% and only 15% for non-responders (p=0.026).

CONCLUSIONS:

The response to chemotherapy is likely to be a significant prognostic factor affecting overall survival after radical hepatic resection for colorectal metastases.

PMID:
19621711
[PubMed - indexed for MEDLINE]
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