Peri-operative chemotherapy for the treatment of resectable liver metastases from colorectal cancer: A systematic review and meta-analysis of randomized trials View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2010-06-21

AUTHORS

Martina Wieser, Stefan Sauerland, Dirk Arnold, Wolff Schmiegel, Anke Reinacher-Schick

ABSTRACT

BackgroundThe role of peri-operative chemotherapy in patients with resected stage IV colorectal cancer (CRC) remains to be defined. This study was aimed at evaluating the effectiveness of peri-operative chemotherapy in patients with resected stage IV CRC by performing a meta-analysis of relevant trials.MethodsWe performed a literature search to identify trials comparing patients with stage IV CRC receiving peri-operative chemotherapy and surgery with patients undergoing surgery alone. The hazard ratio (HR) was estimated to assess any survival advantage of peri-operative chemotherapy.ResultsEight trials conducted on a total of 1174 patients were identified by a literature search. In these trials, HR estimates suggested that peri-operative chemotherapy yielded no survival advantage over surgery alone (HR, 0.94; 95%CI, 0.8-1.10; p = 0.43). In a subset analysis on intra-arterial chemotherapy alone, no survival benefit was evident (HR, 1.0; 95% CI, 0.84-1.21; p = 0.96; I2 = 30%), whereas in the trials involving systemic chemotherapy, the difference between the groups approached statistical significance (HR, 0.74; 95% CI, 0.53-1.04; p = 0.08; I2 = 0%). Both peri-operative treatment groups had a significant recurrence-free survival benefit (HR, 0.78; 95% CI, 0.65-0.95; P = 0.01 for hepatic arterial infusion; and HR, 0.75; 95% CI, 0.62-0.91; p = 0.003 for systemic therapy). The toxicities of chemotherapy were acceptable in most trials.ConclusionsThis is the first meta-analysis demonstrating the importance of peri-operative chemotherapy in the treatment of resected stage IV CRC. Although the results must be carefully interpreted because of some limitations, critical issues were identified that must be resolved by future studies. More... »

PAGES

309

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1471-2407-10-309

DOI

http://dx.doi.org/10.1186/1471-2407-10-309

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1028347950

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/20565923


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185 grid-institutes:grid.9018.0 schema:alternateName Department of Hematology and Oncology, University of Halle, Germany
186 schema:name Department of Hematology and Oncology, University of Halle, Germany
187 rdf:type schema:Organization
 




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