Impact of the type and modalities of preoperative chemotherapy on the outcome of liver resection for colorectal metastases.

Adam, René; Barroso, Eduardo; Laurent, C; Nuzzo, Gennaro; Hubert, Catherine; Mentha, G.; IJzermans, Jan N.M.; Capussotti, Lorenzo; López‐Ben, Santiago; Mirza, D.; Kaiser, Gernot M.; Oussoultzoglou, Elíe; Gruenberger, T.; Poston, G.; Скипенко, О Г

doi:10.1200/jco.2011.29.15_suppl.3519

Cited by 13 publications

(10 citation statements)

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“…Number of CLM with a cut-off value of 3 was added to the widely accepted stratification according to the Fong score. Although already part of the Fong score, this cut off value has recently demonstrated high prognostic value [ 15 ]. The composite endpoint FFS was chosen to adapt to the specific situation in this trial with half of the patients being disease-free within the first months after randomization, compared to the other half receiving 3 months of preoperative treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Resection of CLM is a potentially curative treatment, and reported 5-year survival rates are about 40% [ 10 , 11 ]. Further follow up after resection of liver metastases from colorectal cancer demonstrated long-term survival and finally cure for every fifth patient even in the presence of poor prognostic factors [ 12 - 15 ]. However, with the majority of patients relapsing after liver resection, either intrahepatic (about 70%), extrahepatic (about 50%), or both, further research is urgently warranted [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with 5 risk factors had a 5 year OS rate (5-yOSR) of 14% with a median of 22 months compared to a 5-yOSR of 44% and a median of 51 months in case of one risk factor [ 14 ]. Recently, the international liver metastases survey, including data of about 4500 patients with preoperatively treated CLM, confirmed the poor prognosis of patients with lymph node positive primary, abnormal CEA levels, and a high number of CLM, although cut off value was >3 [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Treatment with bevacizumab and FOLFOXIRI in patients with advanced colorectal cancer: presentation of two novel trials (CHARTA and PERIMAX) and review of the literature

Stein

Glockzin²,

Wienke

et al. 2012

BMC Cancer

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BackgroundMore than half of patients with colorectal cancer will develop metastatic disease either evident at the time of initial diagnosis or during their course of disease. Besides multidisciplinary management further treatment intensification is warranted to improve the still limited prognosis.Methods/designIn these two multi-centre, randomized phase II trials, conducted in Germany, 380 patients with R0-resectable colorectal liver metastases (PERIMAX) and with unresectable, metastatic colorectal cancer (CHARTA) will be recruited. Patients previously untreated for metastatic disease with either synchronous or metachronous metastases are randomly assigned in a 1:1 ratio to resection of colorectal liver metastases followed by postoperative FOLFOX for 6 months or perioperative FOLFOXIRI and bevacizumab for 3 months pre- and postoperative and resection (PERIMAX), or to induction chemotherapy with FOLFOX and bevacizumab +/− irinotecan for a maximum of 6 months followed by maintenance treatment with fluoropyrimidine and bevacizumab. The primary objective of these trials is to evaluate the feasibility and efficacy of FOLFOXIRI and bevacizumab in metastatic colorectal cancer. Primary endpoint is failure free survival rate at 18 months in the PERIMAX trial and progression free survival rate at 9 months in CHARTA. Secondary objectives include efficacy, safety and tolerability.DiscussionThe CHARTA and PERIMAX trials are designed to evaluate the benefits and limitations of a highly active four-drug regimen in distinct treatment situations of metastatic CRC. Eligible patients are classified into resectable liver metastases to be randomized to perioperative treatment with FOLFOXIRI and bevacizumab or postoperative FOLFOX in the PERIMAX, or unresectable metastatic CRC to be randomized between FOLFOX and bevacizumab with or without irinotecan, stratified for clinical groups according to disease and patients’ characteristics in the CHARTA trial.Trial registrationClinical trial identifier CHARTA: NCT01321957, PERIMAX: NCT01540435

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment with bevacizumab and FOLFOXIRI in patients with advanced colorectal cancer: presentation of two novel trials (CHARTA and PERIMAX) and review of the literature

Stein

Glockzin²,

Wienke

et al. 2012

BMC Cancer

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“…Recently, the international liver metastases survey, including data for about 4500 patients with preoperatively treated CLM, confirmed the poor prognosis of patients with lymph node positive primary, abnormal CEA levels and number of CLM, although the cutoff value was three in the current analyses. Furthermore, more than one line and six cycles of preoperative treatment, incomplete macroscopic resection (R2), concomitant extrahepatic metastases and progression during preoperative chemotherapy were associated with poor prognoses [Adam and Barroso, 2011].…”

Section: Prognostic Factors For Liver Resection Of Clmmentioning

confidence: 99%

Systemic treatment of liver metastases from colorectal cancer

Stein

Schmoll

2013

Ther Adv Med Oncol

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Patients presenting with synchronous or metachronous colorectal cancer liver metastases (CLM) should be evaluated for multimodal management with curative intent. Preoperative systemic chemotherapy shows beneficial impact on adjuvant progressionfree survival and also borderline on overall survival, without significantly increasing initially R0 resectable patients postoperative complication rates. Postoperative chemotherapy recommended based on the perioperative trial experience for those patients achieving at least stable disease during preoperative chemotherapy, or based on the adjuvant trials for patients receiving upfront resection. 'Borderline' resectable CLM, preoperative chemotherapy plays an important role in both in achievement of a resectable status and improvement of prognosis. Recent 4 drug combinations demonstrated response rates up to 80% even for advanced disease and are thus promising regimens for further evaluation in patients with resectable or unresectable liver-limited (+/-lung) disease.

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“…Obwohl nach wie vor kontrovers diskutiert, scheint ein Sicherheitsabstand von weniger als 5 mm hinsichtlich der potenziel len Kuration ausreichend zu sein -besonders, wenn sektion von Lebermetastasen (CLM) 5-Jahres-Überlebens-raten (5-Jahres-ÜLR) von bis zu 40% berichtet [4][5][6]. Die weitere Nachverfolgung dieser Patientengruppe zeigt, dass ungefähr jeder fünfte Patient langfristig überlebt und letztlich von der Erkrankung geheilt werden kann [7][8][9]. Trotzdem erleidet die Mehrheit der Patienten im Verlauf ein Rezidiv, das bei etwa 40% (zunächst) nur intrahepatisch, bei der Mehrheit aber ebenfalls extrahepatisch auftritt [10].…”

Section: Chirurgische Resektion Von Lebermetastasenunclassified

Multimodale Therapiestrategien bei Lebermetastasen kolorektaler Karzinome

Stein¹,

Arnold²

2011

Viszeralmedizin

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Obwohl das Vorliegen von Metastasen bei kolorektalen Karzinomen den Beginn einer systemischen Ausbreitung darstellt, ist bei lokalisierter, oligometastasierter Erkrankung – insbesondere bei isolierten Lebermetastasen (CLM) – ein kurativer Therapieansatz möglich. Hierbei sollte ein Vorgehen innerhalb multimodaler Therapiekonzepte, unter Einschluss von Chirurgie, ablativen Techniken und systemischer Therapie, in Betracht gezogen werden. Prä- und/oder postoperative systemische Chemo- und Antikörpertherapie zeigt einen günstigen Einfluss auf das progressionsfreie Überleben und das Gesamtüberleben, ohne die postoperative Komplikationsrate maßgeblich zu erhöhen. In Bezug auf die komplexe Definition der Resektabilität und die erhebliche Zahl von Patienten mit grenzwertig resektablen CLM spielt die präoperative Systemtherapie insbesondere im Hinblick auf die Verbesserung der Prognose und die «Konversion» zur Resektabilität eine wichtige Rolle. Fortschritte in der Leberchirurgie ermöglichen darüber hinaus einer zunehmenden Zahl von Patienten eine Resektion in kurativer Intention.

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Impact of the type and modalities of preoperative chemotherapy on the outcome of liver resection for colorectal metastases.

Cited by 13 publications

References 0 publications

Treatment with bevacizumab and FOLFOXIRI in patients with advanced colorectal cancer: presentation of two novel trials (CHARTA and PERIMAX) and review of the literature

Treatment with bevacizumab and FOLFOXIRI in patients with advanced colorectal cancer: presentation of two novel trials (CHARTA and PERIMAX) and review of the literature

Systemic treatment of liver metastases from colorectal cancer

Multimodale Therapiestrategien bei Lebermetastasen kolorektaler Karzinome

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