Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2006

01-01-2006 | Original Article

Treatment with 5-Fluorouracil/Folinic Acid, Oxaliplatin, and Irinotecan Enables Surgical Resection of Metastases in Patients With Initially Unresectable Metastatic Colorectal Cancer

Authors: Gianluca Masi, MD, Samanta Cupini, MD, Lorenzo Marcucci, MD, Elisa Cerri, MD, Fotios Loupakis, MD, Giacomo Allegrini, MD, Isa Maura Brunetti, MD, Elisabetta Pfanner, MD, Maurizio Viti, MD, Orlando Goletti, MD, Franco Filipponi, MD, Alfredo Falcone, MD

Published in: Annals of Surgical Oncology | Issue 1/2006

Login to get access

Abstract

Background

The prognosis of unresectable metastatic colorectal cancer might be improved if a radical surgical resection of metastases could be performed after a response to chemotherapy.

Methods

We treated 74 patients with unresectable metastatic colorectal cancer (not selected for a neoadjuvant approach) with irinotecan, oxaliplatin, and 5-fluorouracil/leucovorin (FOLFOXIRI and simplified FOLFOXIRI). Because of the high activity of these regimens (response rate, 72%), a secondary curative operation could be performed in 19 patients (26%).

Results

Four patients underwent an extended hepatectomy, nine patients underwent a right hepatectomy, three patients underwent a left hepatectomy, and three patients had a segmental resection. In five patients, surgical removal of extrahepatic disease was also performed. In seven patients, surgical resection was combined with intraoperative radiofrequency ablation. The median overall survival of the 19 patients who underwent operation is 36.8 months, and the 4-year survival rate is 37%. The median overall survival of the 34 patients who were responsive to chemotherapy, but who did not undergo operation, is 22.2 months (P = .0114).

Conclusions

The FOLFOXIRI regimens we studied have significant antitumor activity and allow a radical surgical resection of metastases in patients with initially unresectable metastatic colorectal cancer not selected for a neoadjuvant approach and also those with extrahepatic disease. The median survival of patients with resected disease is promising.
Literature
1.
Greenlee RT, Murray T, Bolden S, Wingo PA. Cancer statistics. CA Cancer J Clin 2000;50:7–33CrossRef
2.
Strangl R, Alterdorf-Hofmann A, Charnley RM, Scheele J. Factors influencing the natural history of colorectal liver metastases. Lancet 1994;343:1405–10CrossRef
3.
Jonker DJ, Maroun JA, Kocha W. Survival benefit of chemotherapy in metastatic colorectal cancer: a meta-analysis of randomized controlled trials. Br J Cancer 2000;82:1789–94CrossRef
4.
Wilson SM, Adson MA. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg 1976;111:330–4CrossRef
5.
Fong Y, Cohen AM, Fortner JG, et al. Liver resection for colorectal metastases. J Clin Oncol 1997;15:938–46CrossRef
6.
Jaeck D, Bachellier P, Guiguet M, et al. Long-term survival following resection of colorectal hepatic metastases. Association Francaise de Chirurgie. Br J Surg 1997;84:977–80CrossRef
7.
Ike H, Shimada H, Ohki S, Togo S, Yamaguchi S, Ichikawa Y. Results of aggressive resection of lung metastases from colorectal carcinoma detected by intensive follow-up. Dis Colon Rectum 2002;45:468–73CrossRef
8.
Sakamoto T, Tsubota N, Iwanaga K, Yuki T, Matsuoka H, Yoshimura M. Pulmonary resection for metastases from colorectal cancer. Chest 2001;119:1069–72. CrossRef
9.
Kobayashi K, Kawamura M, Ishihara T. Surgical treatment for both pulmonary and hepatic metastases from colorectal cancer. J Thorac Cardiovasc Surg 1999;118:1090–6. CrossRef
10.
Mineo TC, Ambrogi V, Tonini G, et al. Longterm results after resection of simultaneous and sequential lung and liver metastases from colorectal carcinoma. J Am Coll Surg 2003;197:386–91. CrossRef
11.
Elias D, Sideris L, Pocard M, et al. Results of R0 resection for colorectal liver metastases associated with extrahepatic disease. Ann Surg Oncol 2004;11:274–80CrossRef
12.
Grothey A, Sargent D, Goldberg RM, et al. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol 2004;22:1209–14CrossRef
13.
Giacchetti S, Itzhaki M, Gruia G, et al. Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery. Ann Oncol 1999;10:663–9. CrossRef
14.
Adam R, Avisar E, Ariche A, et al. Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal. Ann Surg Oncol 2001;8:347–53CrossRef
15.
Folprecht G, Kohne CH. The role of new agents in the treatment of colorectal cancer (review). Oncology 2004;66:1–17CrossRef
16.
Falcone A, Masi G, Allegrini G, et al. Biweekly chemotherapy with oxaliplatin, irinotecan, infusional fluorouracil, and leucovorin: a pilot study in patients with metastatic colorectal cancer. J Clin Oncol 2002;20:4006–14CrossRef
17.
Masi G, Allegrini G, Cupini S, et al. First line treatment of metastatic colorectal cancer with irinotecan, oxaliplatin and 5-fluorouracil/leucovorin (FOLFOXIRI): results of phase II study with a simplified biweekly schedule. Ann Oncol 2004;15:1766–72CrossRef
18.
Buyse M, Thirion P, Carlson RW, et al. Relation between tumour response to first-line chemotherapy and survival in advanced colorectal cancer: a meta-analysis. Lancet 2000;356:373–8. CrossRef
19.
Sobrero AF. Scheduling of fluorouracil: a forget-me-not in the jungle of doublets. J Clin Oncol 2004;22:4–6CrossRef
20.
Pozzo C, Basso M, Cassano A, et al. Neoadjuvant treatment of unresectable liver disease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients. Ann Oncol 2004;15:933–9CrossRef
21.
Negri F, Musolino A, Cunningham D, Pastorino U, Ladas G, Norman AR. Retrospective study of resection of pulmonary metastases in patients with advanced colorectal cancer: the development of a preoperative chemotherapy strategy. Clin Colorectal Cancer 2004;4:101–6CrossRef
Metadata
Title
Treatment with 5-Fluorouracil/Folinic Acid, Oxaliplatin, and Irinotecan Enables Surgical Resection of Metastases in Patients With Initially Unresectable Metastatic Colorectal Cancer
Authors
Gianluca Masi, MD
Samanta Cupini, MD
Lorenzo Marcucci, MD
Elisa Cerri, MD
Fotios Loupakis, MD
Giacomo Allegrini, MD
Isa Maura Brunetti, MD
Elisabetta Pfanner, MD
Maurizio Viti, MD
Orlando Goletti, MD
Franco Filipponi, MD
Alfredo Falcone, MD
Publication date
01-01-2006
Publisher
Springer New York
Published in
Annals of Surgical Oncology / Issue 1/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.03.094

Other articles of this Issue 1/2006

Annals of Surgical Oncology 1/2006 Go to the issue

Original Article

Lymphatic Mapping and Sentinel Lymph Node Biopsy for Patients With Local Recurrence After Breast-Conservation Therapy

Original Article

Interferon γ–Inducible Protein 10 Selectively Inhibits Proliferation and Induces Apoptosis in Endothelial Cells

Original Article

Method of Presenting Oncology Treatment Outcomes Influences Patient Treatment Decision-Making in Metastatic Colorectal Cancer

Original Article

Preoperative Profiling of Symptomatic Breast Cancer by Diagnostic Core Biopsy

Original Article

Effect of Neoadjuvant Chemoradiation on Operative Mortality and Morbidity for Pancreaticoduodenectomy

Original Article

Long-Term Outcomes in Patients With Calciphylaxis From Hyperparathyroidism