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Comparison of adjuvant systemic chemotherapy with or without hepatic arterial infusional chemotherapy after hepatic resection for metastatic colorectal cancer.

Publication ,  Journal Article
House, MG; Kemeny, NE; Gönen, M; Fong, Y; Allen, PJ; Paty, PB; DeMatteo, RP; Blumgart, LH; Jarnagin, WR; D'Angelica, MI
Published in: Ann Surg
December 2011

BACKGROUND: The potential benefit of adjuvant hepatic arterial infusional floxuridine (HAI-FUDR) in addition to modern systemic chemotherapy using oxaliplatin or irinotecan remains unknown for patients with resected liver-confined colorectal metastases (CRLM). The principle aim of this study was to compare outcomes in patients receiving modern systemic chemotherapy with or without HAI-FUDR. METHODS: Between 2000 and 2005, 125 patients underwent resection of CRLM followed by adjuvant HAI-FUDR plus dexamethasone (Dex) and concurrent systemic chemotherapy including oxaliplatin or irinotecan. These patients were compared retrospectively to 125 consecutive patients who received modern systemic chemotherapy alone after liver resection. RESULTS: The median follow-up for all patients was 43 months. There were no differences in clinical risk score, disease-free interval, size of largest CRLM, number of CRLM, or prehepatectomy CEA level between the 2 groups. Adjuvant HAI-FUDR was associated with an improved overall and liver recurrence-free survival (liver RFS) and disease-specific survival (DSS). For the adjuvant HAI-FUDR group, the 5-year liver RFS, overall RFS, and DSS were 75%, 48%, and 79%, respectively, compared to 55%, 25%, and 55% for the systemic alone group (P < 0.01). On multivariate analysis, adjuvant treatment including HAI-FUDR was independently associated with improved liver RFS (HR = 0.34), overall RFS (HR = 0.65), and DSS (HR = 0.39), P < 0.01. CONCLUSIONS: Adjuvant HAI-FUDR combined with modern systemic chemotherapy is independently associated with improved survival compared to adjuvant systemic chemotherapy alone. A randomized clinical trial between these 2 regimens is justified.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 2011

Volume

254

Issue

6

Start / End Page

851 / 856

Location

United States

Related Subject Headings

  • Surgery
  • Oxaliplatin
  • Organoplatinum Compounds
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Irinotecan
  • Infusions, Intra-Arterial
  • Humans
  • Hepatectomy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
House, M. G., Kemeny, N. E., Gönen, M., Fong, Y., Allen, P. J., Paty, P. B., … D’Angelica, M. I. (2011). Comparison of adjuvant systemic chemotherapy with or without hepatic arterial infusional chemotherapy after hepatic resection for metastatic colorectal cancer. Ann Surg, 254(6), 851–856. https://doi.org/10.1097/SLA.0b013e31822f4f88
House, Michael G., Nancy E. Kemeny, Mithat Gönen, Yuman Fong, Peter J. Allen, Philip B. Paty, Ronald P. DeMatteo, Leslie H. Blumgart, William R. Jarnagin, and Michael I. D’Angelica. “Comparison of adjuvant systemic chemotherapy with or without hepatic arterial infusional chemotherapy after hepatic resection for metastatic colorectal cancer.Ann Surg 254, no. 6 (December 2011): 851–56. https://doi.org/10.1097/SLA.0b013e31822f4f88.
House, Michael G., et al. “Comparison of adjuvant systemic chemotherapy with or without hepatic arterial infusional chemotherapy after hepatic resection for metastatic colorectal cancer.Ann Surg, vol. 254, no. 6, Dec. 2011, pp. 851–56. Pubmed, doi:10.1097/SLA.0b013e31822f4f88.
House MG, Kemeny NE, Gönen M, Fong Y, Allen PJ, Paty PB, DeMatteo RP, Blumgart LH, Jarnagin WR, D’Angelica MI. Comparison of adjuvant systemic chemotherapy with or without hepatic arterial infusional chemotherapy after hepatic resection for metastatic colorectal cancer. Ann Surg. 2011 Dec;254(6):851–856.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 2011

Volume

254

Issue

6

Start / End Page

851 / 856

Location

United States

Related Subject Headings

  • Surgery
  • Oxaliplatin
  • Organoplatinum Compounds
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Irinotecan
  • Infusions, Intra-Arterial
  • Humans
  • Hepatectomy