BACKGROUND: Chemotherapy can lead to tumor down-staging in patients with initially unresectable colorectal liver metastases (CRLM); however, more than half of such cases are still considered to be unresectable because of disease progression, including multiple or bilobar CRLM, and an insufficient predicted remnant liver volume. In addition, there is little evidence supporting the use of radiofrequency ablation (RFA) for patients with CRLM. This study compared the safety and efficacy of hepatic resection (HR) combined with RFA versus HR alone after effective chemotherapy in patients with initially unresectable CRLM. METHODS: Data were prospectively collected on 118 consecutive patients with initially unresectable CRLM who received FOLFOX ± bevacizumab as the first-line chemotherapy. 48 of these patients (41%) underwent HR or HR + RFA after the chemotherapy. HR was performed in 35 patients (HR group), and HR + RFA in 13 (HR + RFA group). RESULTS: There was no mortality in either group. Postoperative morbidity rates in the HR group and the HR + RFA group were 17 and 23%, respectively (P = 0.640). Local recurrence at the RFA site occurred in only one tumor (1.6% per lesion, 7.7% per patients). The 3-year progression-free survival was 45.3% in the HR group and 12.8% in the HR + RFA group (P = 0.472). The 3-year overall survival rate was 70.4% in the HR group and 77.1% in the HR + RFA group (P = 0.627). CONCLUSIONS: These results suggest that HR + RFA after effective chemotherapy is a safe procedure with low local recurrence at the RFA site and is a potentially effective treatment option for patients with initially unresectable CRLM.
BACKGROUND: Chemotherapy can lead to tumor down-staging in patients with initially unresectable colorectal liver metastases (CRLM); however, more than half of such cases are still considered to be unresectable because of disease progression, including multiple or bilobar CRLM, and an insufficient predicted remnant liver volume. In addition, there is little evidence supporting the use of radiofrequency ablation (RFA) for patients with CRLM. This study compared the safety and efficacy of hepatic resection (HR) combined with RFA versus HR alone after effective chemotherapy in patients with initially unresectable CRLM. METHODS: Data were prospectively collected on 118 consecutive patients with initially unresectable CRLM who received FOLFOX ± bevacizumab as the first-line chemotherapy. 48 of these patients (41%) underwent HR or HR + RFA after the chemotherapy. HR was performed in 35 patients (HR group), and HR + RFA in 13 (HR + RFA group). RESULTS: There was no mortality in either group. Postoperative morbidity rates in the HR group and the HR + RFA group were 17 and 23%, respectively (P = 0.640). Local recurrence at the RFA site occurred in only one tumor (1.6% per lesion, 7.7% per patients). The 3-year progression-free survival was 45.3% in the HR group and 12.8% in the HR + RFA group (P = 0.472). The 3-year overall survival rate was 70.4% in the HR group and 77.1% in the HR + RFA group (P = 0.627). CONCLUSIONS: These results suggest that HR + RFA after effective chemotherapy is a safe procedure with low local recurrence at the RFA site and is a potentially effective treatment option for patients with initially unresectable CRLM.
Authors: P Therasse; S G Arbuck; E A Eisenhauer; J Wanders; R S Kaplan; L Rubinstein; J Verweij; M Van Glabbeke; A T van Oosterom; M C Christian; S G Gwyther Journal: J Natl Cancer Inst Date: 2000-02-02 Impact factor: 13.506
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Authors: S Giacchetti; B Perpoint; R Zidani; N Le Bail; R Faggiuolo; C Focan; P Chollet; J F Llory; Y Letourneau; B Coudert; F Bertheaut-Cvitkovic; D Larregain-Fournier; A Le Rol; S Walter; R Adam; J L Misset; F Lévi Journal: J Clin Oncol Date: 2000-01 Impact factor: 44.544
Authors: Gunnar Folprecht; Thomas Gruenberger; Wolf O Bechstein; Hans-Rudolf Raab; Florian Lordick; Jörg T Hartmann; Hauke Lang; Andrea Frilling; Jan Stoehlmacher; Jürgen Weitz; Ralf Konopke; Christian Stroszczynski; Torsten Liersch; Detlev Ockert; Thomas Herrmann; Eray Goekkurt; Fabio Parisi; Claus-Henning Köhne Journal: Lancet Oncol Date: 2009-11-26 Impact factor: 41.316
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Authors: Karin Nielsen; Hester J Scheffer; José H Volders; Maurice J D L van der Vorst; Aukje A J M van Tilborg; Emile Fi Comans; E S M de Lange-de Klerk; Colin Sietses; Sybren Meijer; Martijn R Meijerink; M Petrousjka van den Tol Journal: World J Surg Date: 2016-08 Impact factor: 3.352