Adjuvant chemotherapy can prolong recurrence-free survival but did not influence the type of recurrence or subsequent treatment in patients with colorectal liver metastases

Kobayashi, Takashi; Saiura, Akio; Takayama, Tadatoshi; Miyagawa, Shinichi; Yamamoto, Junji; Ijichi, Masateru; Teruya, Masanori; Yoshimi, Fuyo; Kawasaki, Seiji; Koyama, Hiromichi; Oba, Masaru; Takahashi, M.; Mizunuma, Nobuyuki; Matsuyama, Yutaka; Ishihara, Soichiro; Makuuchi, Masatoshi; Kokudo, Norihiro; Hasegawa, Kiyoshi

doi:10.1016/j.surg.2021.04.012

Cited by 8 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this multicenter open-label trial, 180 patients from 11 hospitals were enrolled, and the investigators compared surgery alone vs. metastasectomy followed by systemic oral uracil/tegafur with leucovorin. According to Kokudo et al [ 34 ] following an extended follow-up period of 7.36 years, the RFS was significantly longer in the UFT/LV group compared to the surgery alone group (HR = 0.57; 95% CI, 0.39–0.84; p = 0.004), while OS did not differ significantly between the groups (HR = 0.86; 95% CI, 0.54–1.38; p = 0.54). Due to an insufficient number of events, the measurement of median OS was not feasible.…”

Section: Resultsmentioning

confidence: 99%

“…According to the RoB 2 tool for the randomized clinical trials, the ROBINS-I for the non-randomized trials and the Newcastle–Ottawa scale for the retrospective cohort studies and the case–control study, the eligible studies were evaluated as follows: Five randomized studies of low [ 57 ] or moderate risk [ 33 , 34 , 43 , 60 ] and five of high risk [ 46 , 48 , 56 , 58 , 59 ] ( Appendix A Table A1 ). One non-randomized clinical study in which the risk of bias was judged as serious [ 50 ] ( Appendix A Table A2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Five randomized studies of low [ 57 ] or moderate risk [ 33 , 34 , 43 , 60 ] and five of high risk [ 46 , 48 , 56 , 58 , 59 ] ( Appendix A Table A1 ).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

Georgilis

Gavriatopoulou

Tsilimigras

et al. 2023

JCM

View full text Add to dashboard Cite

The liver is the most common site of colorectal cancer metastatic spread. Although metastasectomy is the gold standard for fit patients with resectable colorectal cancer liver metastases (CRLMs), their management after surgical treatment remains controversial. The objective of this systematic review was to collate the currently available data of the agents used in the adjuvant setting in order to define the most optimal therapeutic strategy. A systematic review of the literature was conducted by searching PubMed/Medline and Cochrane library databases. We included studies that evaluated the efficacy, the tolerability and the safety profile of various chemotherapeutic agents that are used as adjuvant treatment after surgical resection of CRLMs. The outcomes of interest were regression-free survival (RFS), disease-free survival (DFS), overall survival (OS) and severe toxicities. From 543 initial articles, 29 publications with 7028 patients were finally included. In general, the results of the eligible studies indicated that adjuvant therapy after resection of CRLMs led to improved RFS/DFS rates, but this benefit did not contribute to a statistically significant prolongation of OS. Moreover, the choice of the therapeutic strategy, namely systematic or regional chemotherapy or the combination of both, did not seem to have a differential impact on patient outcomes. However, these results should be interpreted with caution since the majority of the chosen studies are of low or moderate quality. In this context, further high-quality clinical trials conducted on patient sub-populations with modern therapies are required in order to reduce in-study and between-study heterogeneity and determine which patients are expected to derive the maximum benefit from adjuvant therapy after surgery for CRLMs.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

Georgilis

Gavriatopoulou

Tsilimigras

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…The importance of the type of recurrence, and thus eligibility for local salvage treatment, has been found in several international studies. 10,29 In a case series of 371 patients at the University of Tokyo (Tokyo, Japan) by Oba and colleagues, 27 patients with resectable patterns of recurrence had substantially improved survival (and longterm cure rates) compared with patients with unresectable recurrences. 27 Oba and colleagues introduced the concept of time to surgical failure, defined as the time from surgery to unresectable relapse or death, and found this endpoint to correlate more strongly with overall survival than with recurrence free survival.…”

Section: Discussionmentioning

confidence: 99%

“…9 Although recurrence free survival and overall survival are highly correlated in patients with nonmetastatic colorectal cancer treated in phase 3 adjuvant trials, 3,4 whether or not this correlation persists in patients with resected colorectal liver metastases has not yet been assessed. Because recurrence after resection of colorectal liver metastases can be effectively salvaged with additional locoregional therapies and systemic chemotherapy, 10 and considering that longer survival after recurrence reduces the asso ciation between recurrencefree survival and overall survival, 11 we hypothesised that recurrencefree survival might not be a reliable surrogate endpoint for overall survival in this patient population. Ongoing clinical trials for the management of patients after resection of colorectal liver metastases are using recurrencefree survival as a primary endpoint; 12 therefore, establishing the appropriateness of this surrogate endpoint for overall survival is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Recurrence-free survival versus overall survival as a primary endpoint for studies of resected colorectal liver metastasis: a retrospective study and meta-analysis

Ecker

Lee²,

Saadat³

et al. 2022

The Lancet Oncology

Self Cite

View full text Add to dashboard Cite

Posthepatectomy but not prehepatectomy chemotherapy was associated with a longer time to recurrence in patients with resectable colorectal liver metastases: Inverse probability of treatment weighting analysis

Yoshizaki

Kawaguchi

Seki

et al. 2023

J Hepato Biliary Pancreat

Self Cite

View full text Add to dashboard Cite

BackgroundPatients with resectable colorectal liver metastases (CLM) are treated with surgery alone, surgery and posthepatectomy chemotherapy, or prehepatectomy chemotherapy and surgery. The optimal approach in terms of survival is unclear. We compared survival in the three treatment groups using inverse probability of treatment weighting (IPTW) analysis.MethodsData from patients undergoing initial CLM resection in 2005–2018 were obtained from a prospectively maintained database. Our group treated resectable CLM with surgery alone but gradually adopted post‐ and prehepatectomy chemotherapy for patients with CLM number ≥5 after 2015. IPTW analysis was employed to adjust the characteristics of the three groups.ResultsOf the 439 patients meeting the inclusion criteria, 175 underwent surgery alone, 135 underwent surgery and posthepatectomy chemotherapy, and 129 underwent prehepatectomy chemotherapy and surgery. After the IPTW adjustment, the demographic and clinicopathological characteristics were well balanced. The IPTW analysis revealed that the recurrence‐free survival was better in patients undergoing surgery and posthepatectomy chemotherapy than in patients undergoing surgery alone (median recurrence‐free survival, 1.3 years vs 0.7 years; P = .018). Overall survival was not significantly different between the three treatment approaches.ConclusionPosthepatectomy but not prehepatectomy chemotherapy prolongs the time to recurrence after curative‐intent resection of CLM.

show abstract

Adjuvant chemotherapy can prolong recurrence-free survival but did not influence the type of recurrence or subsequent treatment in patients with colorectal liver metastases

Cited by 8 publications

References 13 publications

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

Recurrence-free survival versus overall survival as a primary endpoint for studies of resected colorectal liver metastasis: a retrospective study and meta-analysis

Posthepatectomy but not prehepatectomy chemotherapy was associated with a longer time to recurrence in patients with resectable colorectal liver metastases: Inverse probability of treatment weighting analysis

Contact Info

Product

Resources

About