Published in:
01-03-2011 | SSAT/AHPBA Joint Symposium 2010
The Role of Peri-operative Chemotherapy for Resectable Colorectal Liver Metastasis: What Does the Evidence Support?
Authors:
Timothy M. Pawlik, David Cosgrove
Published in:
Journal of Gastrointestinal Surgery
|
Issue 3/2011
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Excerpt
With improved patient selection, better surgical techniques, and more effective cytotoxic chemotherapy agents, 5-year survival following curative intent surgery of colorectal metastasis now approaches 45–60%.
1‐
4 While there have been significant advances in prolonging overall survival of patients with colorectal liver metastasis, many patients still develop recurrent disease. De Jong et al.
5 reported a contemporary experience in which the 5-year disease-free survival was only 30% following curative intent surgery for colorectal liver metastasis, with 60% of patients developing extrahepatic disease at 5 years. Tomlinson et al.
6 noted that approximately one third of actual 5-year survivors succumb to cancer-related death. Noting that the chance of “cure” after hepatectomy was roughly a one-in-six chance, the authors estimated a “maximal cure” rate of only about 25% for patients undergoing surgical resection of colorectal liver metastasis. Given the persistent high recurrence rates and the overall poor “true” long-term survival following surgical resection of colorectal liver metastasis, there has been great interest in the use of adjuvant chemotherapy for patients with resectable colorectal liver metastasis. …
