Timing of Multimodality Therapy for Resectable Synchronous Colorectal Liver Metastases

LAUR Repository

Show simple item record

dc.contributor.author Reddy, Srinevas
dc.contributor.author Zorzi, Daria
dc.contributor.author Barbas, Andrew
dc.contributor.author Pawlik, Timothy
dc.contributor.author Ribero, Dario
dc.contributor.author Abdalla, Eddie
dc.contributor.author Choti, Micheal
dc.contributor.author Kemp, Clinton
dc.contributor.author Vauthey, Jean-Nicolas
dc.contributor.author Morse, Micheal
dc.contributor.author White, Rebecah
dc.contributor.author Clary, Bryan
dc.contributor.author Lum, Ying Wei
dc.date.accessioned 2015-11-18T10:24:34Z
dc.date.available 2015-11-18T10:24:34Z
dc.date.copyright 2009
dc.date.issued 2015-11-18
dc.identifier.issn 1068-9265 en_US
dc.identifier.uri http://hdl.handle.net/10725/2607
dc.description.abstract The optimal timing of chemotherapy relative to resection of synchronous colorectal liver metastases (SCRLM) is not known. The objective of this retrospective multi-institutional study was to assess the influence of chemotherapy administered before and after hepatic resection on long-term outcomes among patients with initially resectable SCRLM treated from 1995 to 2005. Clinicopathologic data, treatments, and long-term outcomes from patients with initially resectable SCRLM who underwent partial hepatectomy at three hepatobiliary centers were reviewed. Four hundred ninety-nine consecutive patients underwent resection; 297 (59.5%) and 264 (52.9%) were treated with chemotherapy before and after resection. Chemotherapy strategies included pre-hepatectomy alone (n = 148, 24.7%), post-hepatectomy alone (n = 115, 23.0%), perioperative (n = 149, 29.0%), and no chemotherapy (n = 87, 17.4%). Male gender (p = 0.0029, HR = 1.41 [1.12–1.77]), node-positive primary tumor (p = 0.0046, HR = 1.40 [1.11–1.77]), four or more SCRLM (p = 0.0005, HR = 1.65 [1.24–2.18]), and post-hepatectomy chemotherapy treatment for 6 months or longer (p = 0.039, HR = 0.75 [0.57–0.99]) were associated with recurrence-free survival after discovery of SCRLM. Carcinoembryonic antigen >200 ng/ml (p = 0.0003, HR = 2.33 [1.48–3.69]), extrahepatic metastatic disease (p = 0.0025, HR = 2.34 [1.35–4.05]), four or more SCRLM (p = 0.033, HR = 1.43 [1.03–2.00]), and post-hepatectomy chemotherapy treatment for 2 months or longer (p < 0.0001, HR = 0.59 [0.45–0.76]) were associated with overall survival. Pre-hepatectomy chemotherapy was not associated with recurrence-free or overall survival. Patients treated with perioperative chemotherapy had similar outcomes as patients treated with post-hepatectomy chemotherapy only. We conclude that chemotherapy administered after but not before resection of SCRLM was associated with improved recurrence-free and overall survival. However, prospective randomized trials are needed to determine the optimal timing of chemotherapy. en_US
dc.language.iso en en_US
dc.title Timing of Multimodality Therapy for Resectable Synchronous Colorectal Liver Metastases en_US
dc.type Article en_US
dc.description.version N/A en_US
dc.title.subtitle A Retrospective Multi-Institutional Analysis en_US
dc.author.school SOM en_US
dc.author.idnumber 20110945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Annals of Surgical Oncology en_US
dc.journal.volume 16 en_US
dc.journal.issue 7 en_US
dc.article.pages 1809-1819 en_US
dc.identifier.doi http://dx.doi.org/10.1245/s10434-008-0181-y en_US
dc.identifier.ctation Reddy, S. K., Zorzi, D., Lum, Y. W., Barbas, A. S., Pawlik, T. M., Ribero, D., ... & Clary, B. M. (2009). Timing of multimodality therapy for resectable synchronous colorectal liver metastases: a retrospective multi-institutional analysis. Annals of surgical oncology, 16(7), 1809-1819. en_US
dc.author.email eddie.abdalla@lau.edu.lb

Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record

Search LAUR

Advanced Search


My Account