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Preoperative chemotherapy in colorectal cancer patients with synchronous liver metastasis

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Title: Preoperative chemotherapy in colorectal cancer patients with synchronous liver metastasis
Authors: Ichikawa, Nobuki Browse this author →KAKEN DB
Kamiyama, Toshiya Browse this author →KAKEN DB
Yokoo, Hideki Browse this author →KAKEN DB
Homma, Shigenori Browse this author →KAKEN DB
Maeda, Yoshiaki Browse this author
Shinohara, Toshiki Browse this author
Tsuruga, Yosuke Browse this author
Kazui, Keizo Browse this author
Iijima, Hiroaki Browse this author
Yoshida, Tadashi Browse this author →KAKEN DB
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: colorectal carcinoma
liver metastasis
oncology
chemotherapy
survival
hepatectomy
Issue Date: Apr-2020
Publisher: Spandidos Publications
Journal Title: Molecular and clinical oncology
Volume: 12
Issue: 4
Start Page: 374
End Page: 383
Publisher DOI: 10.3892/mco.2020.1992
Abstract: The response to preoperative chemotherapy is useful for predicting prognosis in unresectable and resectable disease. However, the prognostic benefit of chemotherapy prior to hepatectomy in patients with colorectal carcinoma and resectable or marginally resectable liver metastases remains unclear. The present study investigated the effect of preoperative chemotherapy on the prognosis of patients with colorectal cancer and resectable or marginally resectable synchronous liver metastasis. A total of 106 patients were retrospectively reviewed, who underwent hepatectomy for colorectal metastasis. The prognosis of 64 patients who received neoadjuvant chemotherapy (NAC) were compared with the 42 patients who did not (non-NAC). Furthermore, a total of 43 patients who responded to chemotherapy were compared with the 21 who did not. Preoperative chemotherapy was administered for 5.7 months, wherein 50 patients (78%) received a single regimen, and 54 (84%) received oxaliplatin. There were more patients with <3 metastases and maximum diameters <5 cm in the non-NAC group. The median survival time was 86.0 and 71.6 months in the NAC and non-NAC groups, respectively (P=0.33). Subgroup analysis on the basis of tumor size and number showed no prognostic differences between the two groups. The median survival time was longer in responders than in non-responders (85 vs. 56 months; P=0.01). However, the median relapse-free survival was equivalent in both groups (16.4 and 10.7 months). Preoperative chemotherapy did not prolong survival. Furthermore, it did not prevent recurrence, even in clinical responders. Therefore, it should not be routinely offered to patients with resectable liver metastasis before their hepatectomy.
Type: article
URI: http://hdl.handle.net/2115/79361
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 神山 俊哉

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