Combination of neoadjuvant chemotherapy with cryotherapy and surgical resection for the treatment of unresectable liver metastases from colorectal carcinoma : Long-term results
✍ Scribed by Michel Rivoire; Franco De Cian; Pierre Meeus; Sylvie Négrier; Henri Sebban; Pierre Kaemmerlen
- Publisher
- John Wiley and Sons
- Year
- 2002
- Tongue
- English
- Weight
- 260 KB
- Volume
- 95
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
Background:
This retrospective study was conducted to assess the safety, efficacy, and long-term results of neoadjuvant chemotherapy and cryotherapy as additional means for eradicating liver metastases from colorectal carcinoma when curative treatment was not possible by resection alone.
Methods:
Between january 1996 and december 1997, 131 patients with unresectable liver metastases were referred to our department and received chemotherapy. after 3-6 months of chemotherapy, curative surgery of liver metastases was considered possible in 57 patients, either by resection alone in 33 patients (25%) or cryotherapy associated with resection in 24 patients (18%). characteristics and survival of patients in the cryotherapy plus resection group were compared with those of the 33 patients in the resection group.
Results:
All patients in the resection group had partial response to neoadjuvant chemotherapy. in the cryotherapy plus resection group, neoadjuvant chemotherapy resulted in 13 partial responses, 9 stable diseases, and 2 disease progressions. the rate of postoperative complications in the entire series was 14%. no major difference was seen between the two groups. after a median follow-up of 48 months, the median survival time was 39 months. the survival rates at 1, 3, and 4 years were similar in both groups: 94, 58, and 37% in the resection group and 92, 50, and 36% in the cryotherapy plus resection group, respectively.
Conclusions:
The combination of neoadjuvant chemotherapy, cryotherapy, and liver resection constitutes a promising treatment strategy for patients with extremely advanced metastatic liver involvement. patients having more than four liver metastases from a colorectal carcinoma or patients with a poor liver reserve due to previous resection should be screened carefully to determine whether they could be candidates for this procedure.