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 Ever 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.

Neoadjuvant chemotherapy followed by hepatectomy for primarily resectable colorectal cancer liver metastases / A. Chiappa, E. Bertani, M. Makuuchi, A.P. Zbar, G. Contino, G. Viale, G. Pruneri, M. Bellomi, P. Della Vigna, M.G. Zampino, N. Fazio, M. L. Travaini, G. Trifirò, C. Corbellini, B. Andreoni. - In: HEPATO-GASTROENTEROLOGY. - ISSN 0172-6390. - 56:91-92(2009), pp. 829-834.

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

A. Chiappa
Primo
;
G. Viale;G. Pruneri;M. Bellomi;B. Andreoni
Ultimo
2009

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 Ever 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.
Colorectal liver metastases; Disease-free survival; Liver resection; Neoadjuvant chemotherapy; Survival
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Settore MED/06 - Oncologia Medica
Settore MED/18 - Chirurgia Generale
Settore MED/08 - Anatomia Patologica
2009
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/72556
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