title: Evaluation of resectability after neoadjuvant chemotherapy for primary non-resectable colorectal liver metastases: A multicenter study.
abstract: OBJECTIVE
  The Kyushu Study Group of Clinical Cancer (KSCC) previously reported the safety and efficacy of neoadjuvant chemotherapy with mFOLFOX6 + bevacizumab for H2/H3 liver metastases of colorectal cancer. The aim of the current study was to evaluate the resectability of these metastases before and after chemotherapy as determined by independent liver surgeons.
  
  
  METHODS
  Between May 2008 and April 2010, 40 patients were registered in a multicenter phase 2 trial of neoadjuvant chemotherapy (KSCC 0802). In Study 1, 5 independent liver surgeons from five different KSCC centers evaluated the resectability of liver metastases of colorectal cancer based on imaging studies performed before and after chemotherapy. Each surgeon was blinded to the other surgeons' evaluations. In addition, no information about the patients' characteristics was provided. In Study 2, 3 surgeons evaluated the resectability of these lesions based on imaging studies with discussion with each other, with the surgeons being provided with information on the patients' characteristics.
  
  
  RESULTS
  In Study 1, 13 patients (36.1%) were evaluated to be resectable at baseline, whereas 17 patients (47.2%) were evaluated to be resectable after chemotherapy. In Study 2, 4 patients (11.1%) were evaluated to be resectable at baseline, compared to 23 patients (63.9%) after chemotherapy.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy with mFOLFOX6 + bevacizumab was confirmed to increase the resectability of non-resectable liver metastases of colorectal cancer according to the independent assessments of surgeons.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan. Electronic address: takatsuki@nagasaki-mc.com.
authors.forename: M
authors.initials: M
authors.lastname: Takatsuki
authors.affiliation: Medical Information Center, Kyushu University Hospital, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tokunaga
authors.affiliation: Department of Surgery, Kurume University Medical Center, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Uchida
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sakoda
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shirabe
authors.affiliation: Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University Hospital, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Beppu
authors.affiliation: Department of Surgery, Saiseikai Fukuoka General Hospital, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Emi
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Oki
authors.affiliation: Clinical Oncology, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Ueno
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Eguchi
authors.affiliation: Department of Surgery, Kurume University School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Akagi
authors.affiliation: Department of Surgery, Kurume University Medical Center, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ogata
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Baba
authors.affiliation: Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Natsugoe
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Maehara
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D003299:Cooperative Behavior; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007400:Interprofessional Relations; D002955:Leucovorin / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D018579:Patient Selection; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed
chemical_list: D009944:Organoplatinum Compounds; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil
keywords: Bevacizumab; Colorectal cancer; Conversion; Liver metastasis; Liver resection; Neoadjuvant chemotherapy; mFOLFOX6