Neoadjuvant treatment of unresectable liver disease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients

Pozzo, Carmelo; Basso, Michele A.; Cassano, Alessandra; Quirino, Michela; Schinzari, Giovanni; Trigila, N.; Vellone, Maria; Giuliante, Felice; Nuzzo, Gennaro; Barone, Carlo

doi:10.1093/annonc/mdh217

Cited by 288 publications

(154 citation statements)

References 23 publications

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“…Most of these patients (10 out of 13) underwent multiple segmental resections. As reported previously, the resection rate following chemotherapy was highest in those patients with large (45 cm) metastases (6 out of 10) (Pozzo et al, 2004). Also, there was no postoperative mortality in the 2 months following surgery.…”

Section: Surgerysupporting

confidence: 78%

“…The treatment was well tolerated and the adverse events that were observed and described previously were those typical of the cytotoxic agents used (Pozzo et al, 2004). There were no delayed onset adverse events.…”

Section: Adverse Eventsmentioning

confidence: 56%

“…Initial unresectability of liver metastases was assessed as described previously, using the criteria set out by the institution at which the study was carried out (Pozzo et al, 2004).…”

Section: Assessmentsmentioning

confidence: 99%

“…Also, there was no postoperative mortality in the 2 months following surgery. One patient experienced anaemia as a consequence of postoperative bleeding (Pozzo et al, 2004).…”

Section: Surgerymentioning

confidence: 99%

“…The present study previously reported that 32.7% of patients with CRC were able to undergo potentially curative surgical resection of initially unresectable liver metastases following neoadjuvant chemotherapy with an irinotecan/5-FU/FA combination (modified FOLFIRI) (Pozzo et al, 2004). This paper reports on the long-term follow-up of these patients, providing data on overall survival, disease-free (DF) survival and time to progression (TTP).…”

mentioning

confidence: 96%

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Final analysis of colorectal cancer patients treated with irinotecan and 5-fluorouracil plus folinic acid neoadjuvant chemotherapy for unresectable liver metastases

et al. 2007

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We have previously reported that neoadjuvant therapy with modified FOLFIRI enabled nearly a third of patients with metastatic colorectal cancer (mCRC) to undergo surgical resection of liver metastases. Here, we present data from the long-term follow-up of these patients. Forty patients received modified FOLFIRI: irinotecan 180 mg m À2 , day 1; folinic acid, 200 mg m À2 ; and 5-fluorouracil: as a 400 mg m À2 bolus, days 1 and 2, and a 48-h continuous infusion 1200 mg m À2 , from day 1. Treatment was repeated every 2 weeks, with response assessed every six cycles. Resected patients received six further cycles of chemotherapy postoperatively. Nineteen (47.5%) of 40 patients achieved an objective response; 13 (33%) underwent resection. After a median follow-up of 56 months, median survival for all patients was 31.5 months: for non-resected patients, median survival was 24 months and was not reached for resected patients. Median time to progression was 14.3 and 5.2 months for all and non-resected patients, respectively. Median disease-free (DF) survival in resected patients was 52.5 months. At 2 years, all patients were alive (8 DF), and at last follow-up, eight were alive (6 DF). Surgical resection of liver metastases after neoadjuvant treatment with modified FOLFIRI in CRC patients achieved favourable survival times.

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Section: Surgerysupporting

confidence: 78%

Section: Adverse Eventsmentioning

confidence: 56%

“…Initial unresectability of liver metastases was assessed as described previously, using the criteria set out by the institution at which the study was carried out (Pozzo et al, 2004).…”

Section: Assessmentsmentioning

confidence: 99%

“…Also, there was no postoperative mortality in the 2 months following surgery. One patient experienced anaemia as a consequence of postoperative bleeding (Pozzo et al, 2004).…”

Section: Surgerymentioning

confidence: 99%

mentioning

confidence: 96%

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Final analysis of colorectal cancer patients treated with irinotecan and 5-fluorouracil plus folinic acid neoadjuvant chemotherapy for unresectable liver metastases

et al. 2007

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Oncological management of colorectal liver metastases in the era of minimal access surgery

Chan

2016

Laparoscopic Liver, Pancreas, and Biliary Surgery

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Neoplasms of the Small Intestine, Vermiform Appendix, and Peritoneum and Carcinoma of the Colon and Rectum

Beasley

Sun

Nussbaum

et al. 2017

Holland‐Frei Cancer Medicine

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Overview Cancers of the small bowel, large bowel, and appendix compromise a multitude of distinct pathologic entities and clinical presentations. While tumors of the small bowel are uncommon with <3% of all alimentary tract tumors and 0.4% of all malignancies arise in the small bowel, colon cancer is the third most common malignant tumor and the fourth most common cause of cancer death worldwide. Although adenocarcinoma remains the common pathology, many advances have been made regarding our diagnoses and management of carcinoid tumors and even to a larger degree in gastrointestinal stromal tumors. Additional advances include our understanding of genetics, new imaging modalities, and minimally invasive surgeries. This chapter will provide a comprehensive review of the management and treatment of cancers of the small bowel, large bowel, and appendix.

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Neoadjuvant treatment of unresectable liver disease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients

Abstract: Neoadjuvant therapy with irinotecan combined with 5-FU/FA enabled a significant proportion of patients with initially unresectable liver metastases to undergo surgical resection. The effects of treatment on survival have yet to be determined.

Cited by 288 publications

References 23 publications

Final analysis of colorectal cancer patients treated with irinotecan and 5-fluorouracil plus folinic acid neoadjuvant chemotherapy for unresectable liver metastases

Final analysis of colorectal cancer patients treated with irinotecan and 5-fluorouracil plus folinic acid neoadjuvant chemotherapy for unresectable liver metastases

Oncological management of colorectal liver metastases in the era of minimal access surgery

Neoplasms of the Small Intestine, Vermiform Appendix, and Peritoneum and Carcinoma of the Colon and Rectum

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