Updated long-term survival for patients with metastatic colorectal cancer treated with liver resection followed by hepatic arterial infusion and systemic chemotherapy

J Surg Oncol. 2016 Apr;113(5):477-84. doi: 10.1002/jso.24189. Epub 2016 Feb 2.

Abstract

Background and objectives: Patients who undergo liver resection for metastatic colorectal cancer (mCRC) have reported 5-year survivals ranging from 25% to 50%. The current study updated long-term survival for patients with resected liver metastases treated with adjuvant hepatic arterial infusion (HAI) and systemic (SYS) chemotherapy.

Methods: Updated survival and recurrence free survival for patients treated on four consecutive adjuvant protocols with HAI and SYS from 1991 to 2009. Patients were divided into two groups: those treated on protocols before 2003 and after 2003. Median follow-up for all patients was 11 years.

Results: All 287 patients enrolled in four prospective protocols after liver resection are included. Patients treated before 2003 had a median follow-up of 15 years, 5 and 10-year survivals of 56% [95%CI: 49-64%] and 40% [95%CI: 32-47%], respectively, and median survival of 71 months. Patients treated after 2003 had a median follow-up of 9 years, 5 and 10-year survivals of 78% [95%CI: 70-84%] and 61% [95%CI: 51-70%], respectively, and median survival has not been reached.

Conclusions: Survival is improving for patients with mCRC who undergo liver resection. These data support the durability of long-term survival in patients who undergo resection followed by adjuvant HAI and SYS therapy. J. Surg. Oncol. 2016;113:477-484. © 2016 Wiley Periodicals, Inc.

Keywords: adjuvant therapy; colorectal cancer; hepatic arterial infusion; liver metastases; survival.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives*
  • Chemotherapy, Adjuvant
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / secondary*
  • Colorectal Neoplasms / therapy
  • Dexamethasone / administration & dosage
  • Disease-Free Survival
  • Female
  • Floxuridine / administration & dosage
  • Fluorouracil
  • Follow-Up Studies
  • Hepatectomy*
  • Humans
  • Infusions, Intra-Arterial
  • Irinotecan
  • Leucovorin
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Organoplatinum Compounds
  • Survival Rate
  • Young Adult

Substances

  • Antineoplastic Agents
  • Organoplatinum Compounds
  • Floxuridine
  • Irinotecan
  • Dexamethasone
  • Leucovorin
  • Fluorouracil
  • Camptothecin

Supplementary concepts

  • Folfox protocol
  • IFL protocol