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01-06-2014 | Gastrointestinal Oncology

Chemotherapy and Targeted Therapy for Patients with Initially Unresectable Colorectal Liver Metastases, Focusing on Conversion Hepatectomy and Long-Term Survival

Authors: Toru Beppu, MD, PhD, FACS, Yuji Miyamoto, MD, PhD, Yasuo Sakamoto, MD,PhD, Katsunori Imai, MD, PhD, Hidetoshi Nitta, MD, PhD, Hiromitsu Hayashi, MD, PhD, Akira Chikamoto, MD, Masayuki Watanabe, MD, PhD, FACS, Takatoshi Ishiko, MD, PhD, Hideo Baba, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Special Issue 3/2014

Abstract

Background

Eight years have passed since the introduction of chemotherapy (chemo) and targeted therapy regimens for colorectal liver metastases (CRLM). This study aimed to clarify the effectiveness of chemo and targeted therapy in facilitating conversion hepatectomy and improving long-term survival in Japanese patients with CRLM.

Methods

A total of 199 patients with CRLM were treated between May 2005 and August 2012. Initial therapies for these patients included straightforward hepatic resection (n = 48; 24 %), induction chemotherapy (n = 148; 74 %), and radiofrequency ablation (n = 3; 2 %).

Results

In 56 of 137 patients (40.1 %) with initially unresectable CRLM, 7.5 courses of chemo and targeted therapy downsized and converted tumors to resectable tumors. The 5-year cumulative overall survival (OS) rate and the median survival time were significantly higher for the resectable CRLM than for the unresectable CRLM (54.6 vs. 5.3 % and 77.3 vs. 21.3 months, respectively; P < .0001). Multivariate analysis revealed that conversion hepatectomy (hazard ratio [HR] 0.19; P < .001) and responder to chemo and targeted therapy (HR 0.46; P < .01) were independent prognostic factors for OS. Multivariate analysis also revealed that left-sided colon or rectal cancer (odds ratio [OR] 8.4; P < .05), H1/H2 metastases (OR 7.3; P < .05), no extrahepatic metastases (OR 52.6; P < .001), and responder to chemo and targeted therapy (OR 6.1; P < .05) were significant predictors of conversion hepatectomy.

Conclusions

A chemo and targeted therapy can facilitate conversion hepatectomy and allow for an excellent prognosis in patients with initially unresectable CRLM.

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Title: Chemotherapy and Targeted Therapy for Patients with Initially Unresectable Colorectal Liver Metastases, Focusing on Conversion Hepatectomy and Long-Term Survival
Authors: Toru Beppu, MD, PhD, FACS
Yuji Miyamoto, MD, PhD
Yasuo Sakamoto, MD,PhD
Katsunori Imai, MD, PhD
Hidetoshi Nitta, MD, PhD
Hiromitsu Hayashi, MD, PhD
Akira Chikamoto, MD
Masayuki Watanabe, MD, PhD, FACS
Takatoshi Ishiko, MD, PhD
Hideo Baba, MD, PhD, FACS
Publication date: 01-06-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3577-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chemotherapy and Targeted Therapy for Patients with Initially Unresectable Colorectal Liver Metastases, Focusing on Conversion Hepatectomy and Long-Term Survival

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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