BACKGROUND: The potential benefit of adjuvant hepatic arterial infusional floxuridine (HAI-FUDR) in addition to modern systemic chemotherapy using oxaliplatin or irinotecan remains unknown for patients with resected liver-confined colorectal metastases (CRLM). The principle aim of this study was to compare outcomes in patients receiving modern systemic chemotherapy with or without HAI-FUDR. METHODS: Between 2000 and 2005, 125 patients underwent resection of CRLM followed by adjuvant HAI-FUDR plus dexamethasone (Dex) and concurrent systemic chemotherapy including oxaliplatin or irinotecan. These patients were compared retrospectively to 125 consecutive patients who received modern systemic chemotherapy alone after liver resection. RESULTS: The median follow-up for all patients was 43 months. There were no differences in clinical risk score, disease-free interval, size of largest CRLM, number of CRLM, or prehepatectomy CEA level between the 2 groups. Adjuvant HAI-FUDR was associated with an improved overall and liver recurrence-free survival (liver RFS) and disease-specific survival (DSS). For the adjuvant HAI-FUDR group, the 5-year liver RFS, overall RFS, and DSS were 75%, 48%, and 79%, respectively, compared to 55%, 25%, and 55% for the systemic alone group (P < 0.01). On multivariate analysis, adjuvant treatment including HAI-FUDR was independently associated with improved liver RFS (HR = 0.34), overall RFS (HR = 0.65), and DSS (HR = 0.39), P < 0.01. CONCLUSIONS: Adjuvant HAI-FUDR combined with modern systemic chemotherapy is independently associated with improved survival compared to adjuvant systemic chemotherapy alone. A randomized clinical trial between these 2 regimens is justified.
BACKGROUND: The potential benefit of adjuvant hepatic arterial infusional floxuridine (HAI-FUDR) in addition to modern systemic chemotherapy using oxaliplatin or irinotecan remains unknown for patients with resected liver-confined colorectal metastases (CRLM). The principle aim of this study was to compare outcomes in patients receiving modern systemic chemotherapy with or without HAI-FUDR. METHODS: Between 2000 and 2005, 125 patients underwent resection of CRLM followed by adjuvant HAI-FUDR plus dexamethasone (Dex) and concurrent systemic chemotherapy including oxaliplatin or irinotecan. These patients were compared retrospectively to 125 consecutive patients who received modern systemic chemotherapy alone after liver resection. RESULTS: The median follow-up for all patients was 43 months. There were no differences in clinical risk score, disease-free interval, size of largest CRLM, number of CRLM, or prehepatectomy CEA level between the 2 groups. Adjuvant HAI-FUDR was associated with an improved overall and liver recurrence-free survival (liver RFS) and disease-specific survival (DSS). For the adjuvant HAI-FUDR group, the 5-year liver RFS, overall RFS, and DSS were 75%, 48%, and 79%, respectively, compared to 55%, 25%, and 55% for the systemic alone group (P < 0.01). On multivariate analysis, adjuvant treatment including HAI-FUDR was independently associated with improved liver RFS (HR = 0.34), overall RFS (HR = 0.65), and DSS (HR = 0.39), P < 0.01. CONCLUSIONS: Adjuvant HAI-FUDR combined with modern systemic chemotherapy is independently associated with improved survival compared to adjuvant systemic chemotherapy alone. A randomized clinical trial between these 2 regimens is justified.
Authors: Ioannis T Konstantinidis; Bas Groot Koerkamp; Richard K G Do; Mithat Gönen; Yuman Fong; Peter J Allen; Michael I D'Angelica; T Peter Kingham; Ronald P DeMatteo; David S Klimstra; Nancy E Kemeny; William R Jarnagin Journal: Cancer Date: 2015-12-22 Impact factor: 6.860
Authors: Bas Groot Koerkamp; Eran Sadot; Nancy E Kemeny; Mithat Gönen; Julie N Leal; Peter J Allen; Andrea Cercek; Ronald P DeMatteo; T Peter Kingham; William R Jarnagin; Michael I D'Angelica Journal: J Clin Oncol Date: 2017-04-20 Impact factor: 44.544
Authors: Bertrand Janne d'Othée; Constantinos T Sofocleous; Nader Hanna; Robert J Lewandowski; Michael C Soulen; Jean-Nicolas Vauthey; Steven J Cohen; Alan P Venook; Matthew S Johnson; Andrew S Kennedy; Ravi Murthy; Jean-Francois Geschwind; Stephen T Kee Journal: J Vasc Interv Radiol Date: 2012-02 Impact factor: 3.464
Authors: Jing Qi; Yuman Fong; Leonard Saltz; Michael I D'Angelica; Nancy E Kemeny; Mithat Gonen; Jinru Shia; Amita Shukla-Dave; William R Jarnagin; William M Jarnagin; Richard K G Do; Lawrence H Schwartz; Jason A Koutcher; Kristen L Zakian Journal: NMR Biomed Date: 2012-09-07 Impact factor: 4.044
Authors: René Adam; Aimery De Gramont; Joan Figueras; Ashley Guthrie; Norihiro Kokudo; Francis Kunstlinger; Evelyne Loyer; Graeme Poston; Philippe Rougier; Laura Rubbia-Brandt; Alberto Sobrero; Josep Tabernero; Catherine Teh; Eric Van Cutsem Journal: Oncologist Date: 2012-09-07