title: Metastatic liver disease of colorectal origin: the value of locoregional immunochemotherapy combined with systemic chemotherapy following liver resection. Results of a prospective randomized study.
abstract: OBJECTIVE
  Liver resection for metastatic liver disease of colorectal origin, although considered as the 'gold standard' of treatment, is associated with limited long-term survival. The aim of this study was to compare overall survival, disease-free survival and the incidence of intra- or extrahepatic recurrence between patients who were randomly assigned to have locoregional chemoimmunotherapy with systemic chemotherapy group A (n = 62 patients) versus those who were treated with systemic immunochemotherapy group B (n = 60 patients).
  
  
  METHODS
  Group A included patients who, after liver resection, received locoregional immunochemotherapy combined with systemic chemotherapy, while group B included patients who had undergone systemic immunotherapy combined with systemic chemotherapy following liver resection. The two groups were matched in terms of sex, age and stage of the disease. Prognostic factors and their impact on disease-free survival were studied in both groups.
  
  
  RESULTS
  Two-year survival was 92% for group A versus 75% for group B, 5-year survival was 73% for group A versus 60% for group B. During the two-year period, 34% of the group A patients versus 52% of those of group B developed either intrahepatic or extrahepatic recurrence of the disease (P < 0.00212).
  
  
  CONCLUSIONS
  From the analysis of the above results it becomes clear that regional immunochemotherapy combined with systemic chemotherapy leads to a decrease in the incidence of disease recurrence and thus to a significant prolongation of the overall survival and of disease-free survival.
authors.affiliation: Department of Surgical Oncology, Ericos Dynan Hospital, Athens, Greece. iasg@iasg.org
authors.forename: N J
authors.initials: NJ
authors.lastname: Lygidakis
authors.forename: G
authors.initials: G
authors.lastname: Sgourakis
authors.forename: L
authors.initials: L
authors.lastname: Vlachos
authors.forename: S
authors.initials: S
authors.lastname: Raptis
authors.forename: M
authors.initials: M
authors.lastname: Safioleas
authors.forename: P
authors.initials: P
authors.lastname: Boura
authors.forename: J
authors.initials: J
authors.lastname: Kountouras
authors.forename: M
authors.initials: M
authors.lastname: Alamani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007167:Immunotherapy; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis