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, 27 patients with colorectal liver metastases (seven males, 20 females, mean age: 58 ± 8 years; range: 40-75) were treated with neoadjuvant chemotherapy. A seven-year survival analysis was performed. Chemotherapy included mainly 5-fluorouracil, leucovorin and either oxaliplatin or irinotecan for a median of eight courses. RESULTS: A total of 16 patients (59%) had synchronous and 11 (41%) metachronous metastases. During pre-operative chemotherapy, tumour regression occurred in ten cases (37%), stable disease in a further ten patients (37%) and progressive disease developed in seven cases (26%). The five-year overall survival for NACT responders was 64% and only 15% for non-responders (p=0.044). CONCLUSIONS: The response to chemotherapy is likely to be a significant prognostic factor affecting survival after liver resection for cure.

Resection of colorectal liver metastases following neo-adjuvant chemotherapy / A. Chiappa, E. Bertani, R. Biffi, U. Pace, G. Viale, G. Pruneri, G. Zampino, N. Fazio, F. Orsi, G. Bonomo, L. Monfardini, P. Della Vigna, B. Andreoni. - In: ECANCERMEDICALSCIENCE. - ISSN 1754-6605. - 1:(2007 Oct 16), pp. 1-11. [10.3332/ecancer.2008.58]

Resection of colorectal liver metastases following neo-adjuvant chemotherapy

A. Chiappa
Primo
;
G. Viale;G. Pruneri;P. Della Vigna
Penultimo
;
B. Andreoni
Ultimo
2007

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, 27 patients with colorectal liver metastases (seven males, 20 females, mean age: 58 ± 8 years; range: 40-75) were treated with neoadjuvant chemotherapy. A seven-year survival analysis was performed. Chemotherapy included mainly 5-fluorouracil, leucovorin and either oxaliplatin or irinotecan for a median of eight courses. RESULTS: A total of 16 patients (59%) had synchronous and 11 (41%) metachronous metastases. During pre-operative chemotherapy, tumour regression occurred in ten cases (37%), stable disease in a further ten patients (37%) and progressive disease developed in seven cases (26%). The five-year overall survival for NACT responders was 64% and only 15% for non-responders (p=0.044). CONCLUSIONS: The response to chemotherapy is likely to be a significant prognostic factor affecting survival after liver resection for cure.
Settore MED/08 - Anatomia Patologica
Settore MED/06 - Oncologia Medica
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Settore MED/18 - Chirurgia Generale
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3223977/?tool=pubmed
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/203572
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