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Cancer. 2011 Oct 1;117(19):4484-92. doi: 10.1002/cncr.26036. Epub 2011 Mar 28.

Is resection of colorectal liver metastases after a second-line chemotherapy regimen justified?

Author information

1
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Abstract

BACKGROUND:

Patient outcomes following resection of colorectal liver metastases (CLM) after second-line chemotherapy regimen is unknown.

METHODS:

From August 1998 to June 2009, data from 1099 patients with CLM were collected prospectively. We retrospectively analyzed outcomes of patients who underwent resection of CLM after second-line (2 or more) chemotherapy regimens.

RESULTS:

Sixty patients underwent resection of CLM after 2 or more chemotherapy regimens. Patients had advanced CLM (mean number of CLM ± standard deviation, 4 ± 3.5; mean maximum size of CLM, 5 ± 3.2 cm) and had received 17 ± 8 cycles of preoperative chemotherapy. In 54 (90%) patients, the switch from the first regimen to another regimen was motivated by tumor progression or suboptimal radiographic response. All patients received irinotecan or oxaliplatin, and the majority (42/60 [70%]) received a monoclonal antibody (bevacizumab or cetuximab) as part of the last preoperative regimen. Postoperative morbidity and mortality rates were 33% and 3%, respectively. At a median follow-up of 32 months, 1-year, 3-year, and 5-year overall survival rates were 83%, 41%, and 22%, respectively. Median chemotherapy-free survival after resection or completion of additional chemotherapy administered after resection was 9 months (95% confidence interval, 4-14 months). Synchronous (vs metachronous) CLM and minor (vs major) pathologic response were independently associated with worse survival.

CONCLUSIONS:

Resection of CLM after a second-line chemotherapy regimen was found to be safe and was associated with a modest hope for definitive cure. This approach represents a viable option in patients with advanced CLM.

PMID:
21446046
PMCID:
PMC3128184
DOI:
10.1002/cncr.26036
[Indexed for MEDLINE]
Free PMC Article

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