BACKGROUND: The objective of this study is to determine whether neoadjuvant chemotherapy reveals occult disease precluding surgical extirpation of initially resectable colorectal cancer liver metastases (CRCLM). METHODS: Demographics, clinicopathologic tumor characteristics, treatments, and post-operative outcomes of patients aged 18-80 years, with one to four initially resectable CRCLM, and without concurrent extra-hepatic (EHMD) or previous metastatic disease were reviewed. RESULTS: Two hundred and two patients evaluated from 2000 to 2010 met study criteria; 88 (43.6%) were given neoadjuvant chemotherapy. Patients treated with neoadjuvant chemotherapy were younger (median 58 years vs. 65 years, P = 0.0096), had shorter disease free interval from resection of primary tumor to CRCLM diagnosis (median 0 months vs. 12 months, P < 0.0001), and had more CRCLM (median 1 [1-3] vs. 1 [1-2], P = 0.0096) compared to untreated counterparts. There were no differences in rates of concurrent EHMD noted intra-operatively and not on pre-operative imaging (4.5% vs. 3.5%, P = 0.7290), greater intra-operatively observed CRCLM compared to pre-operative imaging (25.3% vs. 17.5%, P = 0.2449), hepatic resection and/or ablation (97.7% vs. 100.0%, P = 0.9853), or 6-month disease recurrence after surgical treatment (25.6% vs. 14.9%, P = 0.0882). Only two (2.3%) patients treated with neoadjuvant chemotherapy had disease progression precluding surgical extirpation. CONCLUSIONS: Neoadjuvant chemotherapy for initially resectable CRCLM does not reveal occult disease precluding surgical treatment.
BACKGROUND: The objective of this study is to determine whether neoadjuvant chemotherapy reveals occult disease precluding surgical extirpation of initially resectable colorectal cancer liver metastases (CRCLM). METHODS: Demographics, clinicopathologic tumor characteristics, treatments, and post-operative outcomes of patients aged 18-80 years, with one to four initially resectable CRCLM, and without concurrent extra-hepatic (EHMD) or previous metastatic disease were reviewed. RESULTS: Two hundred and two patients evaluated from 2000 to 2010 met study criteria; 88 (43.6%) were given neoadjuvant chemotherapy. Patients treated with neoadjuvant chemotherapy were younger (median 58 years vs. 65 years, P = 0.0096), had shorter disease free interval from resection of primary tumor to CRCLM diagnosis (median 0 months vs. 12 months, P < 0.0001), and had more CRCLM (median 1 [1-3] vs. 1 [1-2], P = 0.0096) compared to untreated counterparts. There were no differences in rates of concurrent EHMD noted intra-operatively and not on pre-operative imaging (4.5% vs. 3.5%, P = 0.7290), greater intra-operatively observed CRCLM compared to pre-operative imaging (25.3% vs. 17.5%, P = 0.2449), hepatic resection and/or ablation (97.7% vs. 100.0%, P = 0.9853), or 6-month disease recurrence after surgical treatment (25.6% vs. 14.9%, P = 0.0882). Only two (2.3%) patients treated with neoadjuvant chemotherapy had disease progression precluding surgical extirpation. CONCLUSIONS: Neoadjuvant chemotherapy for initially resectable CRCLM does not reveal occult disease precluding surgical treatment.
Authors: Matthieu Faron; Mircea Chirica; Hadrien Tranchard; Pierre Balladur; Aimery de Gramont; Pauline Afchain; Thierry Andre; François Paye Journal: J Gastrointest Cancer Date: 2014-09
Authors: Emerson Y Chen; Skye C Mayo; Thomas Sutton; Matthew R Kearney; Adel Kardosh; Gina M Vaccaro; Kevin G Billingsley; Charles D Lopez Journal: J Gastrointest Cancer Date: 2021-03