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

Antonio Chiappa, Emilio Bertani, Masatoshi Makuuchi, Andrew P. Zbar, Gianmarco Contino, Giuseppe Viale, Giancarlo Pruneri, Massimo Bellomi, Paolo Della Vigna, Maria Giulia Zampino, Nicola Fazio, Maria Laura Travaini, Giuseppe Trifirò, Carlo Corbellini, Bruno Andreoni

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)829-834
Number of pages6
JournalHepato-Gastroenterology
Volume56
Issue number91-92
Publication statusPublished - May 2009

Keywords

  • Colorectal liver metastases
  • Disease-free survival
  • Liver resection
  • Neoadjuvant chemotherapy
  • Survival

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

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