A critical appraisal of the role of neoadjuvant chemotherapy for colorectal liver metastases: a case-controlled study.

Abstract:

BACKGROUND:The aim of this study was to analyze the outcome of patients that received neoadjuvant chemotherapy prior to resection for colorectal liver metastases (CRLM) and compare them with a matched cohort of patients that underwent resection followed by adjuvant chemotherapy. METHODS:687 patients have undergone curative resection between January 1993 and January 2006. In this period, 84 patients received neo-adjuvant chemotherapy and 71 of this group went on to resection. A control group was chosen, matched with these patients, made up of patients who underwent resection followed by adjuvant chemotherapy. RESULTS:There was no difference in clinico-pathological features between the neoadjuvant and the control group. However patients in the control group had more-extended resections and longer hospital stays than those in the neoadjuvant group (p = 0.015). Patients in the control group had an increased incidence of early recurrences (p < 0.001). Despite this, there was no significant difference in either the cancer-specific or the disease-free survival between the two groups of patients. CONCLUSION:Neoadjuvant chemotherapy has a role in the management of patients with disease that is considered initially unresectable as a down-sizing technique. In patients with resectable disease, the test-of-time approach that neoadjuvant therapy offers is yet to be proven.

journal_name

Ann Surg Oncol

authors

Malik HZ,Farid S,Al-Mukthar A,Anthoney A,Toogood GJ,Lodge JP,Prasad KR

doi

10.1245/s10434-007-9533-2

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

3519-26

issue

12

eissn

1068-9265

issn

1534-4681

journal_volume

14

pub_type

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