Survival benefit of neoadjuvant chemotherapy and surgery versus surgery first for resectable colorectal liver metastases: a cohort study

Behrenbruch, Corina; Prabhakaran, Sowmya; Udayasiri, Dilshan; Hollande, Frédéric; Michael, Michael; Hayes, Ian; Heriot, Alexander G.; Knowles, Brett; Thomson, Benjamin

doi:10.1111/ans.16613

Cited by 5 publications

(2 citation statements)

References 23 publications

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“…With newly developed biological agents, further significant benefits were achieved. Almost 60% of populations were evaluated to have tumor response by combining oxaliplatin-based or irinotecan-based chemotherapy with such targeted agents[ 14 ]. In the present study, the 5-year PFS and OS rates were 25.2% and 54.0% for the irinotecan group, respectively.…”

Section: Discussionmentioning

confidence: 99%

Irinotecan- vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients: A retrospective study

Liu¹,

Chen²,

Wang³

et al. 2022

World J Gastrointest Surg

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BACKGROUND Neoadjuvant chemotherapy (NC) improves the survival outcomes of selected patients with colorectal liver metastasis (CRLM). The benefits of irinotecan-based regimens in these patients are still under debate. AIM To compare the benefits of irinotecan- and oxaliplatin-based regimens in patients with resectable CRLM. METHODS From September 2003 to August 2020, 554 patients received NC and underwent hepatectomy for CRLM. Based on a 1:1 propensity score matching (PSM) model, 175 patients who received irinotecan were matched to 175 patients who received oxaliplatin to obtain two balanced groups regarding demographic, therapeutic, and prognostic characteristics. RESULTS Chemotherapy was based on oxaliplatin in 353 (63.7%) patients and irinotecan in 201 (36.3%). After PSM, the 5-year progression-free survival (PFS) and overall survival (OS) rates with irinotecan were 18.0% and 49.7%, respectively, while the 5-year PFS and OS rates with oxaliplatin were 26.0% and 46.8%, respectively. Intraoperative blood loss, operating time, and postoperative complications differed significantly between the two groups. In the multivariable analysis, carbohydrate antigen 19-9, RAS mutation, response to NC, tumor size > 5 cm, and tumor number > 1 were independently associated with PFS. CONCLUSION In NC in patients with CRLM, irinotecan is similar to oxaliplatin in survival outcomes, but irinotecan is superior regarding operating time, intraoperative blood loss, and postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Irinotecan- vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients: A retrospective study

Liu¹,

Chen²,

Wang³

et al. 2022

World J Gastrointest Surg

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“…A randomized controlled trial showed some benefit to disease-free survival but no benefit of overall survival if neoadjuvant ChT with FOLFOX was used in upfront resectable LM [132,133]. Other retrospective studies showed no benefits [134].…”

Section: Crclm-neoadjuvant Chtmentioning

confidence: 99%

Colorectal Cancer Liver Metastasis—State-of-the-Art and Future Perspectives

Ruivo,

Oliveira,

Silva-Vaz

et al. 2023

Gastrointestinal Disorders

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The current management of colorectal cancer liver metastasis (CRCLM) patients involves a multidisciplinary approach, with surgical resection remaining the primary curative option. The advances in liver surgery have improved outcomes, enabling more patients to undergo surgery successfully. In addition, the development of imaging software has improved the preoperative planning and patient selection for surgery and other interventions. Systemic therapies, such as targeted therapies and immunotherapies, have enhanced the chances of complete resection. Targeted agents, in combination with chemotherapy, have shown efficacy in downstaging tumors and increasing resectability. The algorithm approach for these patients continues to evolve, driven by a deeper understanding of the underlying biology. Personalized medicine, guided by molecular profiling and the potential of liquid biopsies in this field, may lead to more tailored treatment strategies. A greater understanding of the immune microenvironment in CRLM may unlock the potential for immune checkpoint inhibitors and novel immunotherapies to become more prominent in the treatment landscape. This review explores the current state-of-the-art treatment of CRCLM and discusses promising future perspectives.

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Impact of preoperative chemotherapy on perioperative morbidity in combined resection of colon cancer and liver metastases

Done

Papanikolaou

Stem

et al. 2023

Journal of Gastrointestinal Surgery

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Survival benefit of neoadjuvant chemotherapy and surgery versus surgery first for resectable colorectal liver metastases: a cohort study

Cited by 5 publications

References 23 publications

Irinotecan- vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients: A retrospective study

Irinotecan- vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients: A retrospective study

Colorectal Cancer Liver Metastasis—State-of-the-Art and Future Perspectives

Impact of preoperative chemotherapy on perioperative morbidity in combined resection of colon cancer and liver metastases

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