[Chemotherapy with curative intent before (neoadjuvant) or after (adjuvant) surgery for colorectal cancer liver metastases].
The 5-year risk of progression after complete resection of liver metastases is of 50% to 75%. Trials which have evaluated adjuvant systemic chemotherapy using 5FU--folinic acid, sometimes in association with intra-arterial chemotherapy, are not powerful and did not demonstrate a clear survival benefit. It is strongly recommended to participate to clinical trials. An adjuvant chemotherapy with the LV5FU2 regimen during 6 months is a reasonable option if the patient has not been included in a trial (professional agreement). A preoperative chemotherapy is not recommended if liver metastases are considered as right away resectable but it should be discussed if resectability is uncertain and/or in case of pejorative factors (professional agreement). If metastases resection has been facilitated or made possible by pre-operative chemotherapy, post-operative resumption of this chemotherapy should also been discussed (professional agreement).
Fédération des spécialités digestives, Hôpital Ambroise Paré-92100 Boulogne.
Philippe
P
Rougier
Rosine
R
Guimbaud
Emmanuel
E
Mitry
Jean-Nicolas
JN
Vaillant
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D018450:Disease Progression; D004334:Drug Administration Schedule; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D015337:Multicenter Studies as Topic; D020360:Neoadjuvant Therapy; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome