Z-M Wang1, Y-Y Chen2, F-F Chen3, S-Y Wang4, B Xiong5. 1. Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: zhiniuer1314@163.com. 2. Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: yuanyuanchen2013@126.com. 3. Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: mailcff@163.com. 4. Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: wangshuyitc@gmail.com. 5. Department of Oncology, Zhongnan Hospital of Wuhan University, Hubei Key of Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, PR China. Electronic address: binxiong1961@gmail.com.
Abstract
AIMS: The purpose of this meta-analysis is to assess the value of peri-operative chemotherapy for patients who have resectable colorectal cancer with liver metastases (CRCLM). The clinical effectiveness of peri-operative chemotherapy for CRCLM patients remains controversial. METHODS: A literature review was performed to compare CRCLM patients receiving peri-operative chemotherapy plus surgery with patients receiving surgery alone. The Hazard ratio (HR), odds ratio (OR) and 95% confidence intervals (95% CIs) were set as effect measures. RESULTS: There were 10 studies included in this meta-analysis, with a total of 1896 patients. There was no advantage in overall survival (OS) for patients receiving peri-operative chemotherapy compared with those who underwent surgery alone (HR, 0.88; 95% CI, [0.77, 1.01]; P = 0.07). However, there was significant benefit in disease-free survival (DFS) in patients who received chemotherapy compared with surgery alone (HR, 0.81; 95% CI, [0.72, 0.91]; P = 0.0007). In a subset analysis, the systemic chemotherapy group showed a DFS benefit (HR, 0.81; 95% CI, [0.69, 0.96]; P = 0.01) compared with different regional chemotherapy. The incidence of post-operative complications was significantly higher in patients who also received chemotherapy compared with the surgery alone group (OR, 1.42; 95% CI, [1.05, 1.92]; P = 0. 02). CONCLUSIONS: There was no significant improvement in OS in CRCLM patients who received peri-operative chemotherapy compared with surgery alone, and chemotherapy significantly increased the post-operative complications. However, this requires further clinical study.
AIMS: The purpose of this meta-analysis is to assess the value of peri-operative chemotherapy for patients who have resectable colorectal cancer with liver metastases (CRCLM). The clinical effectiveness of peri-operative chemotherapy for CRCLM patients remains controversial. METHODS: A literature review was performed to compare CRCLM patients receiving peri-operative chemotherapy plus surgery with patients receiving surgery alone. The Hazard ratio (HR), odds ratio (OR) and 95% confidence intervals (95% CIs) were set as effect measures. RESULTS: There were 10 studies included in this meta-analysis, with a total of 1896 patients. There was no advantage in overall survival (OS) for patients receiving peri-operative chemotherapy compared with those who underwent surgery alone (HR, 0.88; 95% CI, [0.77, 1.01]; P = 0.07). However, there was significant benefit in disease-free survival (DFS) in patients who received chemotherapy compared with surgery alone (HR, 0.81; 95% CI, [0.72, 0.91]; P = 0.0007). In a subset analysis, the systemic chemotherapy group showed a DFS benefit (HR, 0.81; 95% CI, [0.69, 0.96]; P = 0.01) compared with different regional chemotherapy. The incidence of post-operative complications was significantly higher in patients who also received chemotherapy compared with the surgery alone group (OR, 1.42; 95% CI, [1.05, 1.92]; P = 0. 02). CONCLUSIONS: There was no significant improvement in OS in CRCLM patients who received peri-operative chemotherapy compared with surgery alone, and chemotherapy significantly increased the post-operative complications. However, this requires further clinical study.
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