Optimal indication criteria for neoadjuvant chemotherapy in patients with resectable colorectal liver metastases View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-06-13

AUTHORS

Hirofumi Ichida, Yoshihiro Mise, Hiromichi Ito, Takeaki Ishizawa, Yosuke Inoue, Yu Takahashi, Eiji Shinozaki, Kensei Yamaguchi, Akio Saiura

ABSTRACT

BackgroundThere are no optimal indication criteria for neoadjuvant chemotherapy (NAC) in patients with resectable colorectal liver metastases (CLM). The aim of this study was to prospectively assess the survival benefit of selective NAC administration in this patient population based on tumor characteristics.MethodsBorderline resectable CLM (BR-CLM) were defined as four or more liver metastases, CLM larger than 5 cm, or CLM with concomitant resectable extrahepatic metastases. From 2010 to 2015, NAC was administered to BR-CLM patients. Upfront surgery without NAC was performed to patients having clearly resectable CLM (less than 3 lesions, smaller than 5 cm, and no extrahepatic metastases: CR-US group). Survival outcomes of the two groups were assessed.ResultsThe BR-NAC group comprised 73 patients and the CR-US group 172. All patients in the BR-NAC group underwent subsequent resection, as none showed disease progression or chemotherapy-associated liver damage. The 3- and 5-year overall survival rates of the CR-US group were 83.0% and 74.0%, while patients in the BR-NAC group had comparable 3-year and 5-year overall survivals (80.5% and 66.6%, P = 0.397).ConclusionDefining BR-CLM based on tumor characteristics optimizes patient selection for NAC. Favorable overall survival can be achieved by upfront surgery in patients with clearly resectable CLM and by NAC in patients with BR-CLM. More... »

PAGES

100

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http://scigraph.springernature.com/pub.10.1186/s12957-019-1641-5

DOI

http://dx.doi.org/10.1186/s12957-019-1641-5

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https://app.dimensions.ai/details/publication/pub.1117139998

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31196104


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44 aim
45 benefits
46 characteristics
47 chemotherapy
48 colorectal liver metastases
49 criteria
50 damage
51 disease progression
52 extrahepatic metastases
53 favorable overall survival
54 group
55 indication criteria
56 liver damage
57 liver metastases
58 metastasis
59 more liver metastases
60 neoadjuvant chemotherapy
61 outcomes
62 overall survival
63 overall survival rate
64 patient population
65 patient selection
66 patients
67 population
68 progression
69 rate
70 resectable colorectal liver metastases
71 resectable extrahepatic metastases
72 resection
73 selection
74 study
75 subsequent resection
76 surgery
77 survival
78 survival benefit
79 survival outcomes
80 survival rate
81 tumor characteristics
82 upfront surgery
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