Yu-Fen Huang1, Hsiu-Yin Chiang2,3, Shih-Ni Chang2, Feng-Fan Chiang4,5,6. 1. Department of Surgery, Jen-Ai Hospital, Taichung, Taiwan. 2. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. 3. Big Data Center, China Medical University Hospital, Taichung, Taiwan. 4. Division of Surgery, Department of Critical Care Medicine, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sec. 4, Taichung, 40705, Taiwan. hankel.chiang@gmail.com. 5. Department of Surgery, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sec. 4, Taichung, 40705, Taiwan. hankel.chiang@gmail.com. 6. Department of Food and Nutrition, Providence University, Taichung, Taiwan. hankel.chiang@gmail.com.
Abstract
PURPOSE: The role of adjuvant chemotherapy (ACT) in treating patients who have colorectal liver metastases (CLM) and undergo liver metastasectomy (LMS) is unclear in this patient population. We aimed to compare the mortality of patients receiving different ACT (i.e., oxaliplatin-based, irinotecan-based, and 5-fluorouracil-only (5FU)) and different treatment frequencies. METHODS: We included 2583 patients with CLM who underwent LMS (including synchronous LMS [SLMS] and metachronous LMS [MLMS]) in this retrospective cohort study. We used Cox proportional hazard model to obtain hazard ratios (HRs) for mortality. The reference group was 5FU-only ACT when comparing ACT type and the reference group was treatment for ≤ 3 times when comparing ACT frequency. RESULTS: In SLMS patients, oxaliplatin-based ACT (HR = 0.78) and receiving ACT for ≥ 4 times (4-6 times, HR = 0.61; 7-9 times, HR = 0.69; 10-12 times, HR = 0.66) were associated with lower risk of mortality. In MLMS patients, oxaliplatin-based ACT (HR = 0.52), irinotecan-based ACT (HR = 0.64), and receiving ACT for 10-12 times (HR = 0.65) were associated with lower risk of mortality. CONCLUSIONS: In SLMS and MLMS patients, patients who received oxaliplatin-based ACT were more likely to survive than patients who received 5FU-only ACT. In MLMS patients, patients who received irinotecan-based ACT were also more likely to survive than those who received 5FU-only ACT. We recommend a course of at least four to six times of ACT after LMS in this patient population.
PURPOSE: The role of adjuvant chemotherapy (ACT) in treating patients who have colorectal liver metastases (CLM) and undergo liver metastasectomy (LMS) is unclear in this patient population. We aimed to compare the mortality of patients receiving different ACT (i.e., oxaliplatin-based, irinotecan-based, and 5-fluorouracil-only (5FU)) and different treatment frequencies. METHODS: We included 2583 patients with CLM who underwent LMS (including synchronous LMS [SLMS] and metachronous LMS [MLMS]) in this retrospective cohort study. We used Cox proportional hazard model to obtain hazard ratios (HRs) for mortality. The reference group was 5FU-only ACT when comparing ACT type and the reference group was treatment for ≤ 3 times when comparing ACT frequency. RESULTS: In SLMS patients, oxaliplatin-based ACT (HR = 0.78) and receiving ACT for ≥ 4 times (4-6 times, HR = 0.61; 7-9 times, HR = 0.69; 10-12 times, HR = 0.66) were associated with lower risk of mortality. In MLMS patients, oxaliplatin-based ACT (HR = 0.52), irinotecan-based ACT (HR = 0.64), and receiving ACT for 10-12 times (HR = 0.65) were associated with lower risk of mortality. CONCLUSIONS: In SLMS and MLMS patients, patients who received oxaliplatin-based ACT were more likely to survive than patients who received 5FU-only ACT. In MLMS patients, patients who received irinotecan-based ACT were also more likely to survive than those who received 5FU-only ACT. We recommend a course of at least four to six times of ACT after LMS in this patient population.
Authors: Emmanuel Mitry; Anthony L A Fields; Harry Bleiberg; Roberto Labianca; Guillaume Portier; Dongsheng Tu; Donato Nitti; Valter Torri; Dominique Elias; Chris O'Callaghan; Bernard Langer; Giancarlo Martignoni; Olivier Bouché; Franck Lazorthes; Eric Van Cutsem; Laurent Bedenne; Malcolm J Moore; Philippe Rougier Journal: J Clin Oncol Date: 2008-09-15 Impact factor: 44.544
Authors: John Primrose; Stephen Falk; Meg Finch-Jones; Juan Valle; Derek O'Reilly; Ajith Siriwardena; Joanne Hornbuckle; Mark Peterson; Myrddin Rees; Tim Iveson; Tamas Hickish; Rachel Butler; Louise Stanton; Elizabeth Dixon; Louisa Little; Megan Bowers; Siân Pugh; O James Garden; David Cunningham; Tim Maughan; John Bridgewater Journal: Lancet Oncol Date: 2014-04-07 Impact factor: 41.316
Authors: Bernard Nordlinger; Halfdan Sorbye; Bengt Glimelius; Graeme J Poston; Peter M Schlag; Philippe Rougier; Wolf O Bechstein; John N Primrose; Euan T Walpole; Meg Finch-Jones; Daniel Jaeck; Darius Mirza; Rowan W Parks; Laurence Collette; Michel Praet; Ullrich Bethe; Eric Van Cutsem; Werner Scheithauer; Thomas Gruenberger Journal: Lancet Date: 2008-03-22 Impact factor: 79.321