ADJUVANT CHEMOTHERAPY AFTER METASTATECTOMY

: J Surg Oncol. 2009 Sep 21. [Epub ahead of print]

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Resected colorectal liver metastases: Does the survival differ according to postoperative chemotherapy regimen?

Kim SY, Kim HJ, Hong YS, Jung KH, Park JW, Choi HS, Oh JH, Park SJ, Kim SH, Nam BH, Chang HJ, Kim DY.

Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.

BACKGROUND AND OBJECTIVES: We compared clinical outcomes in patients who were treated with different chemotherapeutic regimens after resection of hepatic metastases from colorectal cancer (CRC). METHODS: Between August 2001 and June 2008, 156 patients who entered into chemotherapy of adjuvant intent after hepatic metastasectomy were reviewed retrospectively. RESULTS: Of the 156 patients, 58 patients were treated with oxaliplatin/fluoropyrimidines (group I), 48 with irinotecan/fluoropyrimidines (group II), and 50 with fluoropyrimidines alone (group III). In the univariate analysis, there was a marginally significant difference among the three groups with respect to the disease-free survival (DFS); 23.4 months in group I, 14.1 months in group II, and 16.3 months in group III, P = 0.088). Group I showed better DFS when compared to the other two groups combined (group II and III) (P = 0.03). Multivariable analysis showed a marginally significant gain in the DFS for group I (P = 0.068). Multiple metastases (P = 0.045) and positive resection margin (P = 0.003) were significantly associated with poorer DFS. CONCLUSION: Postoperative combination chemotherapy of oxaliplatin/fluoropyrimidines seemed to show better DFS when compared to fluoropyrimidine monotherapy or irinotecan-based combination in patients who underwent liver metastasectomy. J. Surg. Oncol. (c) 2009 Wiley-Liss, Inc.