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Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential.

Publication ,  Journal Article
Pak, LM; Kemeny, NE; Capanu, M; Chou, JF; Boucher, T; Cercek, A; Balachandran, VP; Kingham, TP; Allen, PJ; DeMatteo, RP; Jarnagin, WR; D'Angelica, MI
Published in: J Surg Oncol
March 2018

BACKGROUND/OBJECTIVES: Combination hepatic artery infusion (HAI) and systemic (SYS) chemotherapy for unresectable CRLM results in high tumor-response rates. This study represents an update of long-term survival and conversion to resectability in patients with unresectable CRLM treated with HAI and SYS chemotherapy in a phase II study. METHOD: The primary endpoint was complete resection. Multivariate and landmark analysis assessed the effect of complete resection on progression-free (PFS) and overall survival (OS). RESULTS: From 2007 to 2012, 64 patients with median of 13 tumors were enrolled; 67% had prior chemotherapy. 33 patients (52%) were converted to resection. Median follow-up among survivors was 81 months. Median PFS and OS were 13 and 38 months, respectively, with 5-year-OS of 36%. Chemotherapy-naïve patients had 5-year-OS of 51%. Conversion to resection was the only independent factor prognostic of improved PFS and OS. Nine of 64 patients (14%) are NED (five since initial resection, three after resection of recurrent disease, one from chemotherapy alone) at median follow-up of 86 months from treatment initiation, and 72 months from last operative intervention. CONCLUSION: Combination HAI and SYS is an effective therapy for high-volume unresectable CRLM, resulting in a high rate of resection, long-term survival, and the potential for cure.

Duke Scholars

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

March 2018

Volume

117

Issue

4

Start / End Page

634 / 643

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Prospective Studies
  • Oxaliplatin
  • Organoplatinum Compounds
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Leucovorin
 

Citation

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MLA
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Pak, L. M., Kemeny, N. E., Capanu, M., Chou, J. F., Boucher, T., Cercek, A., … D’Angelica, M. I. (2018). Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential. J Surg Oncol, 117(4), 634–643. https://doi.org/10.1002/jso.24898
Pak, Linda M., Nancy E. Kemeny, Marinela Capanu, Joanne F. Chou, Taryn Boucher, Andrea Cercek, Vinod P. Balachandran, et al. “Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential.J Surg Oncol 117, no. 4 (March 2018): 634–43. https://doi.org/10.1002/jso.24898.
Pak LM, Kemeny NE, Capanu M, Chou JF, Boucher T, Cercek A, Balachandran VP, Kingham TP, Allen PJ, DeMatteo RP, Jarnagin WR, D’Angelica MI. Prospective phase II trial of combination hepatic artery infusion and systemic chemotherapy for unresectable colorectal liver metastases: Long term results and curative potential. J Surg Oncol. 2018 Mar;117(4):634–643.
Journal cover image

Published In

J Surg Oncol

DOI

EISSN

1096-9098

Publication Date

March 2018

Volume

117

Issue

4

Start / End Page

634 / 643

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Prospective Studies
  • Oxaliplatin
  • Organoplatinum Compounds
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Leucovorin