Evaluation of resectability after neoadjuvant chemotherapy for primary non-resectable colorectal liver metastases: A multicenter study

Abstract Background/Aim The Kyushu Study Group of Clinical Cancer (KSCC) previously reported the safety and efficacy of neoadjuvant chemotherapy with mFOLFOX6 + bevacizumab for H2/H3 liver metastases of colorectal cancer. The aim of the current study was to evaluate the resectability of these metast...

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Published in:European journal of surgical oncology 2016-02, Vol.42 (2), p.184-189
Main Authors: Takatsuki, M, Tokunaga, S, Uchida, S, Sakoda, M, Shirabe, K, Beppu, T, Emi, Y, Oki, E, Ueno, S, Eguchi, S, Akagi, Y, Ogata, Y, Baba, H, Natsugoe, S, Maehara, Y
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bevacizumab
Bevacizumab - administration & dosage
Chemotherapy, Adjuvant
Colorectal cancer
Colorectal Neoplasms - pathology
Conversion
Cooperative Behavior
Female
Fluorouracil - administration & dosage
Hematology, Oncology and Palliative Medicine
Humans
Interprofessional Relations
Leucovorin - administration & dosage
Liver metastasis
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - drug therapy
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Liver resection
Magnetic Resonance Imaging
Male
mFOLFOX6
Middle Aged
Neoadjuvant chemotherapy
Neoadjuvant Therapy
Organoplatinum Compounds - administration & dosage
Patient Selection
Single-Blind Method
Surgery
Tomography, X-Ray Computed
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Summary:Abstract Background/Aim The Kyushu Study Group of Clinical Cancer (KSCC) previously reported the safety and efficacy of neoadjuvant chemotherapy with mFOLFOX6 + bevacizumab for H2/H3 liver metastases of colorectal cancer. The aim of the current study was to evaluate the resectability of these metastases before and after chemotherapy as determined by independent liver surgeons. Methods Between May 2008 and April 2010, 40 patients were registered in a multicenter phase 2 trial of neoadjuvant chemotherapy (KSCC 0802). In Study 1, 5 independent liver surgeons from five different KSCC centers evaluated the resectability of liver metastases of colorectal cancer based on imaging studies performed before and after chemotherapy. Each surgeon was blinded to the other surgeons' evaluations. In addition, no information about the patients' characteristics was provided. In Study 2, 3 surgeons evaluated the resectability of these lesions based on imaging studies with discussion with each other, with the surgeons being provided with information on the patients' characteristics. Results In Study 1, 13 patients (36.1%) were evaluated to be resectable at baseline, whereas 17 patients (47.2%) were evaluated to be resectable after chemotherapy. In Study 2, 4 patients (11.1%) were evaluated to be resectable at baseline, compared to 23 patients (63.9%) after chemotherapy. Conclusion Neoadjuvant chemotherapy with mFOLFOX6 + bevacizumab was confirmed to increase the resectability of non-resectable liver metastases of colorectal cancer according to the independent assessments of surgeons.
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2015.11.007