Format

Send to

Choose Destination
Eur J Surg Oncol. 2015 Sep;41(9):1197-203. doi: 10.1016/j.ejso.2015.05.020. Epub 2015 Jun 11.

Peri-operative chemotherapy for patients with resectable colorectal hepatic metastasis: A meta-analysis.

Author information

1
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: zhiniuer1314@163.com.
2
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: yuanyuanchen2013@126.com.
3
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: mailcff@163.com.
4
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: wangshuyitc@gmail.com.
5
Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: binxiong1961@gmail.com.

Abstract

AIMS:

The purpose of this meta-analysis is to assess the value of peri-operative chemotherapy for patients who have resectable colorectal cancer with liver metastases (CRCLM). The clinical effectiveness of peri-operative chemotherapy for CRCLM patients remains controversial.

METHODS:

A literature review was performed to compare CRCLM patients receiving peri-operative chemotherapy plus surgery with patients receiving surgery alone. The Hazard ratio (HR), odds ratio (OR) and 95% confidence intervals (95% CIs) were set as effect measures.

RESULTS:

There were 10 studies included in this meta-analysis, with a total of 1896 patients. There was no advantage in overall survival (OS) for patients receiving peri-operative chemotherapy compared with those who underwent surgery alone (HR, 0.88; 95% CI, [0.77, 1.01]; P = 0.07). However, there was significant benefit in disease-free survival (DFS) in patients who received chemotherapy compared with surgery alone (HR, 0.81; 95% CI, [0.72, 0.91]; P = 0.0007). In a subset analysis, the systemic chemotherapy group showed a DFS benefit (HR, 0.81; 95% CI, [0.69, 0.96]; P = 0.01) compared with different regional chemotherapy. The incidence of post-operative complications was significantly higher in patients who also received chemotherapy compared with the surgery alone group (OR, 1.42; 95% CI, [1.05, 1.92]; P = 0. 02).

CONCLUSIONS:

There was no significant improvement in OS in CRCLM patients who received peri-operative chemotherapy compared with surgery alone, and chemotherapy significantly increased the post-operative complications. However, this requires further clinical study.

KEYWORDS:

Colorectal cancer; Hepatic metastasis; Meta-analysis; Peri-operative chemotherapy; Resectable; Surgery

PMID:
26094113
DOI:
10.1016/j.ejso.2015.05.020
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center