title: Neoadjuvant chemotherapy followed by hepatectomy for primarily resectable colorectal cancer liver metastases.
abstract: OBJECTIVE
  Hepatic resection in metastatic disease from colorectal cancer offers the best chance in selected cases for long-term survival. Neoadjuvant chemotherapy (NACT) has been advocated in some cases initially deemed irresectable with few reports of the efficacy of such a strategy and the influence of the response to chemotherapy on the outcome of radical hepatic resection.
  
  
  METHODS
  Between December 1995 and May 2005, 88 patients with colorectal liver metastases underwent hepatic resection with curative intent. Twenty-five of these patients, (7 males, 18 females, mean age: 58+/-9 years; range: 40-75 years) deemed as resectable cases at the time of diagnosis were treated with neoadjuvant chemotherapy. A 7-year survival analysis was performed. Chemotherapy included mainly oxaliplatin or irinotecan containing regimens for a median of 6 courses.
  
  
  RESULTS
  Fifteen patients (60%) had synchronous and 10 (40%) metachronous metastases. During preoperative chemotherapy tumor regression occurred in 8 cases (32%); stable disease (SD) in a further 10 patients (40%) and progressive disease (PD) developed in 7 cases (28%). The 5-year overall survival for NACT responders was 71% and only 15% for non-responders (p=0.026).
  
  
  CONCLUSIONS
  The response to chemotherapy is likely to be a significant prognostic factor affecting overall survival after radical hepatic resection for colorectal metastases.
authors.affiliation: Department of General Surgery, European Institute of Oncology, Milano, Italy. antonio.chiappa@unimi.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Chiappa
authors.forename: Emilio
authors.initials: E
authors.lastname: Bertani
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Zbar
authors.forename: Gianmarco
authors.initials: G
authors.lastname: Contino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Pruneri
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
authors.forename: Paolo
authors.initials: P
authors.lastname: Della Vigna
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Zampino
authors.forename: Nicola
authors.initials: N
authors.lastname: Fazio
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Travaini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trifirò
authors.forename: Carlo
authors.initials: C
authors.lastname: Corbellini
authors.forename: Bruno
authors.initials: B
authors.lastname: Andreoni
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D004359:Drug Therapy, Combination; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents