title: Role of neoadjuvant chemotherapy in resectable synchronous colorectal liver metastasis; An international multi-center data analysis using LiverMetSurvey.
abstract: OBJECTIVE
  The use of neo-adjuvant chemotherapy in resectable synchronous liver metastasis is ill defined. The aim of this study was to evaluate neo-adjuvant chemotherapy on outcomes following liver resection for synchronous CLM.
  
  
  METHODS
  An analysis of a multi-centric cohort from the LiverMetSurvey International Registry, who had undergone curative resections for synchronous CLM was undertaken. Patients who received neo-adjuvant chemotherapy prior to liver surgery (group NAS; n = 693) were compared with those treated by surgery alone (group SG; n = 608). Baseline clinicopathological variables were compared. Predictors of overall (OS) and disease free survival (DFS) were subsequently identified.
  
  
  RESULTS
  Clinicopathological comparison of the groups revealed a greater proportion of solitary metastasis in the SG compared to the NAS group (58.8% versus 38.4%; P < 0.001) therefore a separate analysis of solitary versus multi-centric analysis was performed. N-stage (> N1), number of metastasis (> 3), serum CEA (> 5 ng/ml) and no adjuvant chemotherapy independently predicted poorer OS, while N-stage (> N1), serum CEA (> 5 ng/ml) and no adjuvant chemotherapy independently predicted poorer DFS. Neo-adjuvant chemotherapy did not independently affect outcome.
  
  
  CONCLUSIONS
  We present an analysis of a large multi-center series of the role of neo-adjuvant chemotherapy in resectable CLM and demonstrate no survival advantage in this setting.
authors: Department of Hepatopancreatobiliary and Liver Transplantation Surgery, University Hospitals Birmingham, United Kingdom.
authors: Glenn K
authors: GK
authors: Bonney
authors: Chris
authors: C
authors: Coldham
authors: Rene
authors: R
authors: Adam
authors: Gernot
authors: G
authors: Kaiser
authors: Eduardo
authors: E
authors: Barroso
authors: Lorenzo
authors: L
authors: Capussotti
authors: Christophe
authors: C
authors: Laurent
authors: Cees
authors: C
authors: Verhoef
authors: Gennaro
authors: G
authors: Nuzzo
authors: Dominique
authors: D
authors: Elias
authors: Real
authors: R
authors: Lapointe
authors: Catherine
authors: C
authors: Hubert
authors: Santiago
authors: S
authors: Lopez-Ben
authors: Marek
authors: M
authors: Krawczyk
authors: Darius F
authors: DF
authors: Mirza
mesh_terms: D002272:Carcinoembryonic Antigen / Q000097:blood; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005060:Europe / Q000453:epidemiology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009367:Neoplasm Staging; D012042:Registries; D012189:Retrospective Studies
chemical_list: D002272:Carcinoembryonic Antigen
keywords: chemotherapy; liver metastasis; liver surgery; neo-adjuvant; synchronous