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Survival and recurrence after neo-adjuvant chemotherapy and liver resection for colorectal metastases – A 10-year study
European Journal of Surgical Oncology, 06/30/09

Karanjia ND et al. - In a study to assess the outcome of colorectal liver metastases (CRLM) treated by a combination of neo-adjuvant chemotherapy and surgery, it was determined that neo-adjuvant chemotherapy followed by liver surgery is associated with improved survival and low CIRM and re-resection rates.

Methods

283 consecutive pts underwent liver resection for CRLM over 10 yrs with curative intent.
Pts received chemotherapy preoperatively for synchronous and early (<2 yrs) metachronous metastases.
Univariate and multivariate analyses were used to identify mortality risk factors.

Results

Overall survival (OS) at 1, 3, and 5 yrs was 90%, 59.2% and 46.1%, respectively.
Disease free survival at 1, 3, and 5 yrs was 68.1%, 34.8%, and 27.9%, respectively.
Operative mortality was 2.1% and morbidity was 23.7%.
Pts with macroscopic diaphragm invasion by tumour, CEA >100 ng/ml, tumour size >5 cm or cancer involved resection margins (CIRM) had a significantly worse OS.
Incidence of CIRM and re-resection was 4.9% and 4.5%, respectively.

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