TY - JOUR
T1 - Impact of preoperative and postoperative FOLFOX chemotherapies in patients with resectable colorectal liver metastasis
AU - Faron, Matthieu
AU - Chirica, Mircea
AU - Tranchard, Hadrien
AU - Balladur, Pierre
AU - de Gramont, Aimery
AU - Afchain, Pauline
AU - Andre, Thierry
AU - Paye, François
PY - 2014/9/1
Y1 - 2014/9/1
N2 - PURPOSE: Whether the survival benefit of perioperative FOLFOX in patients with liver metastases of colorectal cancer (LMCRC) is provided by preoperative chemotherapy (CT), postoperative CT, or both remains unclear. This study aimed to evaluate, in patients with resectable LMCRC, the survival impact of preoperative and postoperative separately.METHODS: Between 2000 and 2010, the 179 patients (126 men, age 61 ± 11 years) with initially resectable LMCRC, who underwent liver resection (LR) and were offered pre- and/or postoperative FOLFOX were included. Twenty-four (13%) patients did not receive CT, 27(15%) patients received only preoperative CT, 71 (40%) patients received only postoperative CT, and 57 (32%) patients received both pre- and postoperative CT.RESULTS: Operative morbidity and mortality rates were 19 and 0.6%, respectively. At 1, 3, and 5 years, OS and DFS rates were 97, 66, 46 and 60, 32, and 24%, respectively. Postoperative FOLFOX was an independent predictor of increased OS (HR = 0.55 [95% CI, 0.35-0.87] p = 0.01) and DFS (HR = 0.54 [0.36-0.82] p = 0.0017), whereas the synchronous onset of the metastasis and the presence of radiographically occult liver metastases were independent predictors of poorer OS. Alternatively, preoperative FOLFOX had no significant influence on OS (HR = 0.96 [0.57-1.60] p = 0.83) or DFS (HR = 1.05 [0.66-1.66] p = 0.87).CONCLUSIONS: The survival benefit of FOLFOX in patients with resectable LMCRC may be provided by postoperative rather than preoperative administration.
AB - PURPOSE: Whether the survival benefit of perioperative FOLFOX in patients with liver metastases of colorectal cancer (LMCRC) is provided by preoperative chemotherapy (CT), postoperative CT, or both remains unclear. This study aimed to evaluate, in patients with resectable LMCRC, the survival impact of preoperative and postoperative separately.METHODS: Between 2000 and 2010, the 179 patients (126 men, age 61 ± 11 years) with initially resectable LMCRC, who underwent liver resection (LR) and were offered pre- and/or postoperative FOLFOX were included. Twenty-four (13%) patients did not receive CT, 27(15%) patients received only preoperative CT, 71 (40%) patients received only postoperative CT, and 57 (32%) patients received both pre- and postoperative CT.RESULTS: Operative morbidity and mortality rates were 19 and 0.6%, respectively. At 1, 3, and 5 years, OS and DFS rates were 97, 66, 46 and 60, 32, and 24%, respectively. Postoperative FOLFOX was an independent predictor of increased OS (HR = 0.55 [95% CI, 0.35-0.87] p = 0.01) and DFS (HR = 0.54 [0.36-0.82] p = 0.0017), whereas the synchronous onset of the metastasis and the presence of radiographically occult liver metastases were independent predictors of poorer OS. Alternatively, preoperative FOLFOX had no significant influence on OS (HR = 0.96 [0.57-1.60] p = 0.83) or DFS (HR = 1.05 [0.66-1.66] p = 0.87).CONCLUSIONS: The survival benefit of FOLFOX in patients with resectable LMCRC may be provided by postoperative rather than preoperative administration.
UR - http://www.scopus.com/inward/record.url?scp=85027945308&partnerID=8YFLogxK
U2 - 10.1007/s12029-014-9594-y
DO - 10.1007/s12029-014-9594-y
M3 - Article
C2 - 24610400
AN - SCOPUS:85027945308
SN - 1941-6628
VL - 45
SP - 298
EP - 306
JO - Journal of gastrointestinal cancer
JF - Journal of gastrointestinal cancer
IS - 3
ER -