Resection of colorectal liver metastases after second-line chemotherapy : is it worthwhile? A LiverMetSurvey analysis of 6415 patients

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Adam , R , Yi , B , Innominato , P F , Barroso , E , Laurent , C , Giuliante , F , Capussotti , L , Lapointe , R , Regimbeau , J-M , Lopez-Ben , S , Isoniemi , H , Hubert , C , Lin , J-K , Gruenberger , T , Elias , D , Skipenko , O G , Guglielmi , A & LiverMetSurvey Int Contributing 2017 , ' Resection of colorectal liver metastases after second-line chemotherapy : is it worthwhile? A LiverMetSurvey analysis of 6415 patients ' , European Journal of Cancer , vol. 78 , pp. 7-15 . https://doi.org/10.1016/j.ejca.2017.03.009

Title: Resection of colorectal liver metastases after second-line chemotherapy : is it worthwhile? A LiverMetSurvey analysis of 6415 patients
Author: Adam, Rene; Yi, Bin; Innominato, Pasquale F.; Barroso, Eduardo; Laurent, Christophe; Giuliante, Felice; Capussotti, Lorenzo; Lapointe, Real; Regimbeau, Jean-Marc; Lopez-Ben, Santiago; Isoniemi, Helena; Hubert, Catherine; Lin, Jen-Kou; Gruenberger, Thomas; Elias, Dominique; Skipenko, Oleg G.; Guglielmi, Alfredo; LiverMetSurvey Int Contributing
Contributor: University of Helsinki, Clinicum
Date: 2017-06
Language: eng
Number of pages: 9
Belongs to series: European Journal of Cancer
ISSN: 0959-8049
URI: http://hdl.handle.net/10138/236228
Abstract: Purpose: Patient outcome after resection of colorectal liver metastases (CLM) following second-line preoperative chemotherapy (PCT) performed for insufficient response or toxicity of the first-line, is little known and has here been compared to the outcome following first-line. Patients and methods: From January 2005 to June 2013, 5624 and 791 consecutive patients of a prospective international cohort received 1 and 2 PCT lines before CLM resection (group 1 and 2, respectively). Survival and prognostic factors were analysed. Results: After a mean follow-up of 30.1 months, there was no difference in survival from CLM diagnosis (median, 3-, and 5-year overall survival [OS]: 58.6 months, 76% and 49% in group 2 versus 58.9 months, 71% and 49% in group 1, respectively, P = 0.32). After hepatectomy, disease-free survival (DFS) was however shorter in group 2: 17.2 months, 27% and 15% versus 19.4 months, 32% and 23%, respectively (P = 0.001). Among the initially unresectable patients of group 1 and 2, no statistical difference in OS or DFS was observed. Independent predictors of worse OS in group 2 were positive primary lymph nodes, extrahepatic disease, tumour progression on second line, R2 resection and number of hepatectomies/year Conclusion: CLM resection following second-line PCT, after oncosurgically favourable selection, could bring similar OS compared to what observed after first-line. For initially unresectable patients, OS or DFS is comparable between first-and second-line PCT. Surgery should not be denied after the failure of first-line chemotherapy. (C) 2017 Elsevier Ltd. All rights reserved.
Subject: Colorectal cancer
Liver metastasis
Preoperative chemotherapy
Second line
Hepatectomy
LONG-TERM SURVIVAL
SYSTEMIC CHEMOTHERAPY
PHASE-II
CANCER
OXALIPLATIN
INFUSION
TRIAL
5-FLUOROURACIL
PROGRESSION
LEUCOVORIN
3122 Cancers
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