A critical appraisal of the role of neoadjuvant chemotherapy for colorectal liver metastases: a case-controlled study. Ann Surg Oncol 2007 Dec;14(12):3519-26
Date
10/04/2007Pubmed ID
17912590DOI
10.1245/s10434-007-9533-2Scopus ID
2-s2.0-36348992494 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
BACKGROUND: The aim of this study was to analyze the outcome of patients that received neoadjuvant chemotherapy prior to resection for colorectal liver metastases (CRLM) and compare them with a matched cohort of patients that underwent resection followed by adjuvant chemotherapy.
METHODS: 687 patients have undergone curative resection between January 1993 and January 2006. In this period, 84 patients received neo-adjuvant chemotherapy and 71 of this group went on to resection. A control group was chosen, matched with these patients, made up of patients who underwent resection followed by adjuvant chemotherapy.
RESULTS: There was no difference in clinico-pathological features between the neoadjuvant and the control group. However patients in the control group had more-extended resections and longer hospital stays than those in the neoadjuvant group (p = 0.015). Patients in the control group had an increased incidence of early recurrences (p < 0.001). Despite this, there was no significant difference in either the cancer-specific or the disease-free survival between the two groups of patients.
CONCLUSION: Neoadjuvant chemotherapy has a role in the management of patients with disease that is considered initially unresectable as a down-sizing technique. In patients with resectable disease, the test-of-time approach that neoadjuvant therapy offers is yet to be proven.
Author List
Malik HZ, Farid S, Al-Mukthar A, Anthoney A, Toogood GJ, Lodge JP, Prasad KRAuthor
Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAntineoplastic Combined Chemotherapy Protocols
Case-Control Studies
Chemotherapy, Adjuvant
Colorectal Neoplasms
Combined Modality Therapy
Disease-Free Survival
Female
Follow-Up Studies
Hepatectomy
Humans
Liver Neoplasms
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Recurrence, Local
Survival Rate
Treatment Outcome
