title: Postoperative prophylactic hepatic arterial infusion chemotherapy for stage III colorectal cancer: a retrospective study.
abstract: BACKGROUND
  Radical resection is the main treatment for colorectal cancer (CRC), but metastasis or recurrence is common in which liver metastasis accounted for 83% of the cases. Therefore, the prognosis of patients with advanced CRC may be improved if liver metastasis is prevented. This study aims to investigate the efficacy of hepatic arterial infusion chemotherapy (HAIC) on liver metastases of stage III CRC patients after curative resection.
  
  
  METHODS
  Between 2002 and 2008, 287 stage III CRC patients who had undergone radical resection were included in this study. According to postoperative adjuvant chemotherapy modality, these patients were divided into two groups. Patients in the combined therapy group received two cycles of HAIC plus four cycles of systemic chemotherapy, while patients in the monotherapy group received six cycles of systemic chemotherapy alone. The HAIC regimen consisted of hepatic arterial infusion of oxaliplatin (OXA, 85 mg/m2) on day 1 and 5-fluorouracil (5-FU, 2,400 mg/m2) on days 2 and 3 followed by a vein infusion of folinic acid (FA, 200 mg/m2) as a 2-hour infusion on days 2 and 3. The systemic chemotherapy regimen consisted of a 2-hour infusion of OXA (85 mg/m2) on day 1 followed by FA (200 mg/m2) as a 2-hour infusion on days 2 and 3, and by 5-FU (2,400 mg/m2) as a 48-hour infusion. This was repeated every 4 weeks. All cases were followed up for 5 years or until death. The 5-year overall survival, disease-free survival, liver metastases-free survival, and the overall liver metastases rates were retrospectively compared.
  
  
  RESULTS
  Significant differences were found in the 5-year overall survival (combined therapy, 70.71%; monotherapy, 57.14%;P=0.014), disease-free survival (combined therapy, 69.29%; monotherapy, 55.78%;P=0.021), and liver metastases-free survival rates (combined therapy, 70%; monotherapy, 56.46%;P=0.019).
  
  
  CONCLUSIONS
  Prophylactic adjuvant HAIC can prevent metachronous liver metastases and improve the prognosis of patients with stage III CRC after curative resection.
authors.affiliation: Department of General Surgery.
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of General Surgery.
authors.forename: Xin Rong
authors.initials: XR
authors.lastname: Sun
authors.affiliation: Department of General Surgery.
authors.forename: Wen Ming
authors.initials: WM
authors.lastname: Feng
authors.affiliation: Department of General Surgery.
authors.forename: Ying
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of Radiology, First People's Hospital affiliated to Huzhou University Medical College, Huzhou, People's Republic of China.
authors.forename: Yin Yuan
authors.initials: YY
authors.lastname: Zheng
keywords: chemotherapy; colorectal cancer; hepatic arterial infusion chemotherapy; liver metastases