Annals of Surgical Oncology

, Volume 8, Issue 4, pp 347–353

Five-Year Survival Following Hepatic Resection After Neoadjuvant Therapy for Nonresectable Colorectal [Liver] Metastases

  • R. Adam
  • E. Avisar
  • A. Ariche
  • S. Giachetti
  • D. Azoulay
  • D. Castaing
  • F. Kunstlinger
  • F. Levi
  • F. Bismuth
Original Articles

DOI: 10.1007/s10434-001-0347-3

Cite this article as:
Adam, R., Avisar, E., Ariche, A. et al. Ann Surg Oncol (2001) 8: 347. doi:10.1007/s10434-001-0347-3

Abstract

Background: Surgical resection is the most effective treatment for colorectal liver metastases but only a minority of patients are candidates for a potentially curative resection. Our experience with neoadjuvant chemotherapy followed by resection and five years survival analysis of the patients treated is presented.

Methods: Between February of 1988 and September of 1996, 701 patients with unresectable colorectal liver metastases were treated with neoadjuvant chemotherapy. Four categories of nonresectable disease were defined: large size, ill location, multinodularity, and extrahepatic disease. Liver resection was performed in those patients whose disease became resectable. After resection, the patients were followed up every 3 months. A 5-year survival analysis by the different categories described was performed.

Results: Ninety-five patients (13.5%) were found to be resectable on reevaluation and underwent a potentially curative resection. There was no perioperative mortality, and the complication rate was 23%. As of December of 1999, 87 patients have completed 5 years of follow-up. The overall 5-year survival is 35% from the time of resection and 39% from the onset of chemotherapy. Respective 5-year survival rates are 60% for large tumors, 49% for ill-located lesions, 34% for multinodular disease, and 18% for liver metastases with extrahepatic disease. In this latter category, however, a 35% 5-year survival was found when all the patients with extrahepatic disease were analyzed rather than only those for whom extrahepatic disease was the main cause of nonresectability.

Conclusions: Neoadjuvant chemotherapy enables liver resection in some patients with initially unresectable colorectal metastases. Long-term survival is similar to that reported for a priori surgical candidates.

Key Words:

Neoadjuvant therapy Chronotherapy Colorectal liver metastases Nonresectable hepatic metastases 

Copyright information

© The Society of Surgical Oncology, Inc. 2001

Authors and Affiliations

  • R. Adam
    • 1
    • 3
  • E. Avisar
    • 1
  • A. Ariche
    • 1
  • S. Giachetti
    • 2
  • D. Azoulay
    • 1
  • D. Castaing
    • 1
  • F. Kunstlinger
    • 1
  • F. Levi
    • 2
  • F. Bismuth
    • 1
  1. 1.Centre Hépato-Biliaire (RA, EA, AA, DA, DC, FK, HB)Service de Cancérologie Hopital Paul BrousseVillejuifFrance
  2. 2.Centre de Chronothérapie (SG, FL)Service de Cancérologie Hopital Paul BrousseVillejuifFrance
  3. 3.Centre Hepato-BiliaireHopital Paul BrousseVILLEJUIF CedexFrance

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