Efficacy of perioperative chemotherapy in resected colorectal liver metastasis: A systematic review and meta-analysis

Bosma, Nicholas; Keehn, Alysha; Lee‐Ying, Richard M.; Karim, Safiya; MacLean, Anthony R.; Brenner, Darren R.

doi:10.1016/j.ejso.2021.07.024

Cited by 8 publications

(7 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All the RCTs met the primary endpoint of DFS, but none were able to capture a statistically significant benefit in the underpowered secondary endpoint of OS. This was recently corroborated in a meta-analysis with a statistically significant improvement in DFS (HR 0.71, 95% CI: 0.61-0.82; p < 0.001) but not OS (HR 0.87, 95% CI: 0.73-1.04; p = 0.136) with the use of adjuvant chemotherapy [53]. The most widely cited randomized trial in this setting is the EORTC 40983 trial by Nordlinger et al [21,36].…”

Section: Benefit Of Systemic Therapy In Resectable Metastatic Liver D...mentioning

confidence: 65%

“…For example, worse survival outcomes were observed in the new EPOC trial with the addition of cetuximab to chemotherapy [57]. A recent meta-analysis stratifying monotherapy fluoropyrimidine vs. oxaliplatin-based chemotherapy showed a non-statistical trend favoring the former (HR 0.76, 95% CI: 0.57-1.01; p = 0.059) [53]. It is possible that this relates to poor tolerance and complications of post-hepatectomy oxaliplatin chemotherapy.…”

Section: The Optimal Systemic Therapy In Resectable Crlmmentioning

confidence: 99%

See 1 more Smart Citation

Systemic Therapy and Its Surgical Implications in Patients with Resectable Liver Colorectal Cancer Metastases. A Report from the Western Canadian Gastrointestinal Cancer Consensus Conference

et al. 2022

Self Cite

View full text Add to dashboard Cite

The Western Canadian Gastrointestinal Cancer Consensus Conference (WCGCCC) convened virtually on 4 November 2021. The WCGCCC is an interactive multi-disciplinary conference attended by health care professionals, including surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals from across four Western Canadian provinces, British Columbia, Alberta, Saskatchewan, and Manitoba, who are involved in the care of patients with gastrointestinal cancer. They participated in presentation and discussion sessions for the purpose of developing recommendations on the role of systemic therapy and its optimal sequence in patients with resectable metastatic colorectal cancer.

show abstract

Section: Benefit Of Systemic Therapy In Resectable Metastatic Liver D...mentioning

confidence: 65%

Section: The Optimal Systemic Therapy In Resectable Crlmmentioning

confidence: 99%

Systemic Therapy and Its Surgical Implications in Patients with Resectable Liver Colorectal Cancer Metastases. A Report from the Western Canadian Gastrointestinal Cancer Consensus Conference

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…To date, there is no evidence that adjuvant systemic therapy improves OS among patients with resected CRLM. 45,46 Given the promising OS data reported in multiple trials and the fact that 70% of recurrences after CRLM surgery occur in the liver, 47 intensification of perioperative liver-directed therapy with HAIP therapy is an attractive option.…”

Section: Hepatic Arterial Infusion Pumpmentioning

confidence: 99%

Regional Therapy for Colorectal Cancer Liver Metastases: Which Modality and When?

Raphael

Karanicolas

2022

JCO

View full text Add to dashboard Cite

For patients with unresectable colorectal liver metastases (uCRLM), regional therapies leverage the unique, dual blood supply to the liver; the hepatic artery is the main blood supply for liver tumors, whereas the portal vein supplies most normal hepatic parenchyma. Infusion of cancer therapies via the hepatic artery allows selective delivery to the tumors with relative sparing of normal liver tissue and little extrahepatic exposure, thus limiting systemic side effects. There is a paucity of randomized controlled trial evidence to inform the optimal integration of regional therapies into the management of CRLM. Hepatic arterial infusion pump (HAIP) chemotherapy has a potential survival benefit when used in the adjuvant setting after resection of CRLM. HAIP chemotherapy can be safely given with contemporary systemic therapies and is associated with a high objective response and rate of conversion to resectability in patients with uCRLM. Drug-eluting beads coated with irinotecan transarterial chemoembolization is associated with high objective response rates within the liver and has a well-established safety profile in patients with uCRLM. Transarterial radioembolization achieves high rates of response within the liver but is not associated with improvements in overall survival or quality of life in the first- or second-line setting for uCRLM. The best treatment approach is the one that most aligns with a given patients' values, preferences, and philosophy of care. In the first-line setting, HAIP could be offered to motivated patients who hope to achieve conversion to resectability. After progression on chemotherapy, HAIP, transarterial chemoembolization, and transarterial radioembolization are valuable treatment options to consider for patients with liver-limited or liver-predominant CRLM who seek to optimize response rates and regional control.

show abstract

“…Im New EPOC Trial wurde die Behandlung um Antikörper ergänzt und führte zu einem schlechteren Überleben in der Gruppe, die Cetuximab erhalten hatte [38] bemerkenswert ist, dass selbst im New EPOC Trial überwiegend Patienten mit einer geringen Tumorlast behandelt wurden. Die aktuelle Evidenz lässt daher an der Sinnhaftigkeit der bereits in Leitlinien verankerten adjuvanten Chemotherapie nach Lebermetastasenresektion deutlichen Zweifel aufkommen [39]. Diese werden insbesondere durch die Ergebnisse des nach 13 Jahren abgeschlossenen JCOG0603 Trial verstärkt [40], welches keinen Überlebensvorteil für eine adjuvante Chemotherapie nach Resektion zeigen konnte, gleichzeitig aber eine hohe Rate schwerer Neurotoxizität der Chemotherapie (> 50 %) nachweisen konnte.…”

Section: Systemtherapie Als Teil Der Multimodalen Behandlungsstrategieunclassified

Parenchymsparende Operationen oder anatomische Resektionen bei Lebermetastasen des kolorektalen Karzinoms?

Ghamarnejad

Stavrou

2022

Zentralbl Chir

View full text Add to dashboard Cite

ZusammenfassungDarmkrebs ist eine der häufigsten Todesursachen in der westlichen Welt. Die Hälfte der Patienten entwickelt kolorektale Lebermetastasen (CRLM), dabei weisen weniger als 30% der Patienten zum Zeitpunkt der Diagnose eine chirurgisch resektable Metastasierung auf. Im Falle einer Resektabilität bietet die klassische anatomische (Major-)Hepatektomie eine hohe R0-Resektionsrate, allerdings bei gleichzeitig erhöhter Morbidität und Mortalität. In den letzten 2 Jahrzehnten wurden die potenziellen Vorteile der parenchymsparenden Hepatektomie (PSH) in Bezug auf die onkologischen Gesamtergebnisse, das Überleben und die Re-Resektion im Falle eines Rezidivs („Salvageability“) nachgewiesen. Der Beitrag fasst die aktuellen Erkenntnisse zur PSH als chirurgische Therapieoption zusammen und diskutiert den aktuellen „state of the art“ in verschiedenen Szenarien.

show abstract

Efficacy of perioperative chemotherapy in resected colorectal liver metastasis: A systematic review and meta-analysis

Cited by 8 publications

References 44 publications

Systemic Therapy and Its Surgical Implications in Patients with Resectable Liver Colorectal Cancer Metastases. A Report from the Western Canadian Gastrointestinal Cancer Consensus Conference

Systemic Therapy and Its Surgical Implications in Patients with Resectable Liver Colorectal Cancer Metastases. A Report from the Western Canadian Gastrointestinal Cancer Consensus Conference

Regional Therapy for Colorectal Cancer Liver Metastases: Which Modality and When?

Parenchymsparende Operationen oder anatomische Resektionen bei Lebermetastasen des kolorektalen Karzinoms?

Contact Info

Product

Resources

About