Journal of Gastrointestinal Surgery

, Volume 13, Issue 1, pp 74–84

Multiagent Chemotherapy for Isolated Colorectal Liver Metastases: A Single-centered Retrospective Study


    • Department of SurgeryDuke University Medical Center
  • Gloria Broadwater
    • Department of Cancer Center BiostatisticsDuke University Medical Center
  • Donna Niedzwiecki
    • Department of Biostatistics and BioinformaticsDuke University Medical Center
  • Andrew S. Barbas
    • Department of SurgeryDuke University Medical Center
  • Herbert I. Hurwitz
    • Department of MedicineDuke University Medical Center
  • Johanna C. Bendell
    • Department of MedicineDuke University Medical Center
  • Michael A. Morse
    • Department of MedicineDuke University Medical Center
  • Bryan M. Clary
    • Department of SurgeryDuke University Medical Center
original article

DOI: 10.1007/s11605-008-0617-5

Cite this article as:
Reddy, S.K., Broadwater, G., Niedzwiecki, D. et al. J Gastrointest Surg (2009) 13: 74. doi:10.1007/s11605-008-0617-5



Few studies identifying variables associated with prognosis after resection of colorectal liver metastases (CLM) account for treatment with multiagent chemotherapy (fluoropyrmidines with irinotecan, oxaliplatin, bevacizumab, and/or cetuximab). The objective of this retrospective study was to determine the effect of multiagent chemotherapy on long-term survival after resection of CLM.


Demographics, clinicopathologic tumor characteristics, treatments, and long-term outcomes were reviewed.


From 1996 to 2006, 230 patients underwent resection of CLM. Treatment strategies before and after resection included fluoropyrimidine monotherapy (n = 34 and n = 39), multiagent chemotherapy (n = 81 and n = 73), and observation (n = 115 and n = 118). Prehepatectomy treatment strategy was not associated with overall survival. Actuarial 4-year survival was 63%, 39%, and 40% for patients treated with multiagent chemotherapy, fluoropyrimidine monotherapy, and observation after hepatectomy, p = 0.06. Posthepatectomy multiagent chemotherapy (p = 0.04, HR 0.52 [0.27–1.03]), duration of posthepatectomy chemotherapy treatment of 2 months or longer (p = 0.05, HR 0.49 [0.25–0.99]), carcino-embryonic antigen level >10 ng/mL (p = 0.03, HR 2.09, 95% CI [1.32–3.32]), and node positive primary tumor (p = 0.002, HR 1.79 [1.06–3.02]) were associated with overall survival in multivariate analysis.


The association of posthepatectomy multiagent chemotherapy with overall survival in this retrospective study indicates the need for prospective randomized trials comparing multiagent chemotherapy and fluoropyrimidine monotherapy for CLM.


Colorectal liver metastasesChemotherapyHepatic resection

Copyright information

© The Society for Surgery of the Alimentary Tract 2008