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Use of neoadjuvant and postoperative chemotherapy with surgical resection of colorectal cancer hepatic metastases

  • Published:
Current Colorectal Cancer Reports

Abstract

Hepatic metastases from colorectal cancer are common in patients presenting with an initial diagnosis of metastatic disease or at the time of recurrence. For many patients, the liver may be the only site of metastatic disease. Surgical resection of the metastases may provide long-term benefit, but their size, number, or location may limit the possibility of a resection. A growing body of literature from both retrospective patient series and prospective clinical trials suggests that preoperative therapy may enhance the chance for resection and improve outcome for initially unresectable or not optimally resectable metastases. In selected situations, neoadjuvant chemotherapy also may be beneficial for patients with potentially resectable metastases. Further trials are needed to refine the guidelines for preoperative and perioperative chemotherapy.

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References and Recommended Reading

  1. Jemal A, Siegel R, Ward E, et al.: Cancer statistics, 2007. CA Cancer J Clin 2007, 57:43–66.

    PubMed  Google Scholar 

  2. Jessup JM, Stewart AK, Menck HR: The National Cancer Data Base report on patterns of care for adenocarcinoma of the rectum, 1985–95. Cancer 1998, 83:2408–2418.

    Article  PubMed  CAS  Google Scholar 

  3. Jessup JM, McGinnis LS, Steele GD Jr, et al.: The National Cancer Data Base. Report on colon cancer. Cancer 1996, 78:918–926.

    Article  PubMed  CAS  Google Scholar 

  4. Ohlsson B, Palsson B: Follow-up after colorectal cancer surgery. Acta Oncologica 2003, 42:816–826.

    Article  PubMed  Google Scholar 

  5. Weiss L, Grundmann E, Torhorst J, et al.: Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol 1986, 150:195–203.

    Article  PubMed  CAS  Google Scholar 

  6. Garden OJ, Rees M, Poston GJ, et al.: Guidelines for resection of colorectal cancer liver metastases. Gut 2006, 55(Suppl 3):iii1–iii8.

    Article  PubMed  Google Scholar 

  7. Poston GJ, Adam R, Alberts S, et al.: OncoSurge: a strategy for improving resectability with curative intent in metastatic colorectal cancer. J Clin Oncol 2005, 23:7125–7134.

    Article  PubMed  Google Scholar 

  8. Abdalla EK, Vauthey JN, Ellis LM, et al.: Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 2004, 239:818–825, discussion 825–817.

    Article  PubMed  Google Scholar 

  9. Evrard S, Becouarn Y, Fonck M, et al.: Surgical treatment of liver metastases by radiofrequency ablation, resection, or in combination. Eur J Surg Oncol 2004, 30:399–406.

    Article  PubMed  CAS  Google Scholar 

  10. Adam R, Avisar E, Ariche A, et al.: Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal [liver] metastases. Ann Surg Oncol 2001, 8:347–353.

    Article  PubMed  CAS  Google Scholar 

  11. Fong Y: Surgical therapy of hepatic colorectal metastasis. CA Cancer J Clin 1999, 49:231–255.

    Article  PubMed  CAS  Google Scholar 

  12. Petrowsky H, Gonen M, Jarnagin W, et al.: Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis. Ann Surg 2002, 235:863–871.

    Article  PubMed  Google Scholar 

  13. Fong Y, Blumgart LH: Hepatic colorectal metastasis: current status of surgical therapy [review]. Oncology (Williston Park) 1998, 12:1489–1498.

    CAS  Google Scholar 

  14. Kelly H, Goldberg RM: Systemic therapy for metastatic colorectal cancer: current options, current evidence. J Clin Oncol 2005, 20:4553–4560.

    Article  CAS  Google Scholar 

  15. Falcone A, Ricci S, Brunetti I, et al.: Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest. J Clin Oncol 2007, 25:1670–1676.

    Article  PubMed  CAS  Google Scholar 

  16. Bismuth H, Adam R, Lévi F, et al.: Resection of non-resectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 1996, 224:509–520, discussion 520–522.

    Article  PubMed  CAS  Google Scholar 

  17. Alberts SR, Horvath WL, Sternfeld WC, et al.: Oxaliplatin, fluorouracil, and leucovorin for patients with unresectable liver-only metastases from colorectal cancer: a North Central Cancer Treatment Group phase II study. J Clin Oncol 2005, 23:9243–9249.

    Article  PubMed  CAS  Google Scholar 

  18. Pozzo C, Basso M, Cassano A, et al.: Neoadjuvant treatment of unresectable liver disease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients. Ann Oncol 2004, 15:933–939.

    Article  PubMed  CAS  Google Scholar 

  19. Tabernero J, Van Cutsem E, Diaz-Rubio E, et al.: Phase II trial of cetuximab in combination with fluorouracil, leucovorin, and oxaliplatin in the first-line treatment of metastatic colorectal cancer. J Clin Oncol 2007, 25:5225–5232.

    Article  PubMed  CAS  Google Scholar 

  20. Adam R, Aloia T, Lévi F, et al.: Hepatic resection after rescue cetuximab treatment for colorectal liver metastases previously refractory to conventional systemic therapy. J Clin Oncol 2007, 25:4593–4602.

    Article  PubMed  CAS  Google Scholar 

  21. Emmanouilides C, Sfakiotaki G, Androulakis N, et al.: Front-line bevacizumab in combination with oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX) in patients with metastatic colorectal cancer: a multicenter phase II study. BMC Cancer 2007, 7:91.

    Article  PubMed  CAS  Google Scholar 

  22. Kemeny N, Huang Y, Cohen AM, et al.: Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med 1999, 341:2039–2048.

    Article  PubMed  CAS  Google Scholar 

  23. Kemeny NE, Gonen M: Hepatic arterial infusion after liver resection. N Engl J Med 2005, 352:734–735.

    Article  PubMed  CAS  Google Scholar 

  24. Kemeny MM, Adak S, Gray B, et al.: Combined-modality treatment for resectable metastatic colorectal carcinoma to the liver: surgical resection of hepatic metastases in combination with continuous infusion of chemotherapy—an intergroup study. J Clin Oncol 2002, 20:1499–1505.

    Article  PubMed  Google Scholar 

  25. Nordlinger B, Sorbye H, Collette L, et al.: Final results of the EORTC Intergroup randomized phase III study 40983 (EPOC) evaluating the benefit of peri-operative FOLFOX4 chemotherapy for patients with potentially resectable colorectal cancer liver metastases [abstract]. J Clin Oncol 2007, 25(Suppl):Abstract LBA5.

  26. Adam R, Pascal G, Castaing D, et al.: Tumor progression while on chemotherapy: a contraindication to liver resection for multiple colorectal metastases? Ann Surg 2004, 240:1052–1061, discussion 1061–1064.

    Article  PubMed  Google Scholar 

  27. Rubbia-Brandt L, Giostra E, Brezault C, et al.: Importance of histological tumor response assessment in predicting the outcome in patients with colorectal liver metastases treated with neo-adjuvant chemotherapy followed by liver surgery. Ann Oncol 2007, 18:299–304.

    Article  PubMed  CAS  Google Scholar 

  28. Wicherts DA, de Haas RJ, Lévi F, et al.: Complete pathological response of colorectal liver metastases after neoadjuvant chemotherapy: myth or reality? [abstract]. J Clin Oncol 2007, 25:179s.

    Google Scholar 

  29. Benoist S, Brouquet A, Penna C, et al.: Complete response of colorectal liver metastases after chemotherapy: Does it mean cure? J Clin Oncol 2006, 24:3939–3945.

    Article  PubMed  Google Scholar 

  30. Allen PJ, Kemeny N, Jarnagin W, et al.: Importance of response to neoadjuvant chemotherapy in patients undergoing resection of synchronous colorectal liver metastases. J Gastrointest Surg 2003, 7:109–115, discussion 116–117.

    Article  PubMed  Google Scholar 

  31. Benoist S, Nordlinger B: Neoadjuvant treatment before resection of liver metastases. Eur J Surg Oncol 2007, 33(Suppl 2):S35–S41.

    PubMed  Google Scholar 

  32. Vauthey JN, Pawlik TM, Ribero D, et al.: Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol 2006, 24:2065–2072.

    Article  PubMed  CAS  Google Scholar 

  33. Fernandez FG, Ritter J, Goodwin JW, et al.: Effect of steatohepatitis associated with irinotecan or oxaliplatin pretreatment on resectability of hepatic colorectal metastases. J Am Coll Surg 2005, 200:845–853.

    Article  PubMed  Google Scholar 

  34. Ellis LM, Curley SA, Grothey A: Surgical resection after downisizing of colorectal liver metastasis in the era of bevacizumab. J Clin Oncol 2005, 23:4853–4855.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55901, USA

    Steven R. Alberts

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Correspondence to Steven R. Alberts.

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Alberts, S.R. Use of neoadjuvant and postoperative chemotherapy with surgical resection of colorectal cancer hepatic metastases. Curr colorectal cancer rep 4, 100–105 (2008). https://doi.org/10.1007/s11888-008-0017-y

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  • DOI: https://doi.org/10.1007/s11888-008-0017-y

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