Systematic review of systemic adjuvant, neoadjuvant and perioperative chemotherapy for resectable colorectal-liver metastases

Khoo, Emily; O’Neill, Stephen; Brown, Ewan; Wigmore, Stephen J.; Harrison, Ewen M

doi:10.1016/j.hpb.2016.03.001

Cited by 80 publications

(64 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The selection of patients for resection of CRLM is based on a number of patient, tumor and anatomical factors [18e20]. There is no broad consensus on the use of neoadjuvant treatment or whether response should be emphasized in treatment selection [5,21]. Radiological response evaluation can be performed with different methods based on size measurements, or morphological and metabolic changes of liver lesions.…”

Section: Discussionmentioning

confidence: 99%

Heterogeneous radiological response to neoadjuvant therapy is associated with poor prognosis after resection of colorectal liver metastases

Brunsell

Cengija

Sveen

et al. 2019

European Journal of Surgical Oncology

View full text Add to dashboard Cite

a b s t r a c tIntroduction: Surgery combined with perioperative chemotherapy has become standard of care in patients with resectable colorectal liver metastases. However, poor outcome is expected for a significant subgroup. The clinical implications of inter-metastatic heterogeneity remain largely unknown. In a prospective, population-based series of patients undergoing resection of multiple colorectal liver metastases, the aim was to investigate the prevalence and prognostic impact of heterogeneous response to neoadjuvant chemotherapy. Materials and Methods: Radiological response to treatment was evaluated in a lesion-specific manner in 2e5 metastases per patient. Change of lesion diameter was evaluated and response/progression was classified according to three different size thresholds; 3, 4 and 5 mm. A heterogeneous response was defined as progression and response of different metastases in the same patient. Results: In total, 142 patients with 585 liver metastases were examined with the same radiological method (MRI or CT) before and after neoadjuvant treatment. Heterogeneous response to treatment was seen in 16 patients (11%) using the 3 mm size change threshold, and this group had a 5-year cancerspecific survival of 19% compared to 49% for patients with response in all lesions (p ¼ 0.003). Cut-off values of 4e5 mm were less sensitive for detecting a heterogeneous response, but the survival difference was similar and significant. Conclusion: A subgroup of patients with multiple colorectal liver metastases had heterogeneous radiological response to neoadjuvant chemotherapy and poor prognosis. The evaluation of response pattern is easy to perform, feasible in clinical practice and, if validated, a promising biomarker for treatment decisions.

show abstract

Section: Discussionmentioning

confidence: 99%

Heterogeneous radiological response to neoadjuvant therapy is associated with poor prognosis after resection of colorectal liver metastases

Brunsell

Cengija

Sveen

et al. 2019

European Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Overall, a total duration of 6 months of perioperative chemotherapy is recommended . In terms of adjuvant chemotherapy, there is no definitive consensus for adjuvant chemotherapy in patients with resection of CRLM, although some studies have shown an advantage of adjuvant chemotherapy . Surgery should be avoided in cases of progression as the survival benefit of patients who underwent hepatic resection during progression of disease while on chemotherapy is much more limited than that of patients with partial response or stability…”

Section: Multidisciplinary Approach For Crlmmentioning

confidence: 99%

Multidisciplinary approach of liver metastases from colorectal cancer

Adam

Kitano

2019

Annals of Gastroent Surgery

133

View full text Add to dashboard Cite

Colorectal cancer liver metastases (CRLM) represent most of the causes of death in patients with colorectal cancer. Surgical resection is the only treatment that can provide the possibility of prolonged survival, or even cure, for patients with CRLM. Over the last few decades, survival of these patients has improved dramatically thanks to more effective chemotherapy, extension of surgical indications, and development of new surgical procedures. In particular, patients with initially unresectable CRLM can achieve downsizing of the tumor by using various chemotherapies and the tumor can become resectable. It has been shown that such patients have a 33% 5‐year survival and a 23% 10‐year survival rate after surgery, which is a little bit lower than that of patents with resectable CRLM but significantly higher than patients without surgery. However, a decision‐making strategy for patients with CRLM is difficult because there is a wide variety of treatments and no definitive consensus. As an example, much variation among institutions exists on the resectability rate in patients with unresectable CRLM. Also, it is recommended that all patients with CRLM be managed by a multidisciplinary approach (MDA) to select the best strategy. In the future, new treatment procedures (e.g. immune checkpoint blockade, liver transplantation) may contribute to improve prognosis; hence, the necessity for MDA for the treatment of CRLM will further increase.

show abstract

“…Considering the negative relationship between CALI and postoperative morbidity, it is advised to adapt surgical management when CALI is diagnosed. Moreover, with decreased chemotherapy responsiveness, shortened overall survival and increasing doubts about the usefulness of neoadjuvant chemotherapy in certain patient groups, it could even be speculated that some patients would benefit from immediate resection instead of neoadjuvant chemotherapy. Prospective registration such as the ALPPS (Associated Liver Partition and Portal vein Ligation for Staged hepatectomy) Registry provides a way to obtain a higher level of evidence on this topic.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases

Zhao

Mierlo

Gómez-Ramírez

et al. 2017

British Journal of Surgery

100

View full text Add to dashboard Cite

show abstract

Systematic review of systemic adjuvant, neoadjuvant and perioperative chemotherapy for resectable colorectal-liver metastases

Cited by 80 publications

References 37 publications

Heterogeneous radiological response to neoadjuvant therapy is associated with poor prognosis after resection of colorectal liver metastases

Heterogeneous radiological response to neoadjuvant therapy is associated with poor prognosis after resection of colorectal liver metastases

Multidisciplinary approach of liver metastases from colorectal cancer

Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases

Contact Info

Product

Resources

About