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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2015

01-06-2015 | Hepatobiliary Tumors

Comparison of Complete Pathologic Response and Hepatic Injuries Between Hepatic Arterial Infusion and Systemic Administration of Oxaliplatin in Patients with Colorectal Liver Metastases

Authors: Marc Antoine Allard, MD, Mylène Sebagh, MD, Gaëlle Baillie, MD, Antoinette Lemoine, MD, PhD, Peggy Dartigues, MD, François Faitot, MD, Matthieu Faron, MD, Valérie Boige, MD, PhD, Fabrizio Vitadello, MD, Eric Vibert, MD, PhD, Dominique Elias, MD, PhD, René Adam, MD, PhD, Diane Goéré, MD, PhD, Antonio Sa Cunha, MD

Published in: Annals of Surgical Oncology | Issue 6/2015

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Abstract

Background

Whether hepatic arterial infusion (HAI) of oxaliplatin influences the rates of complete pathologic response (CPR) and severe oxaliplatin-related lesions (SOxL) in patients with colorectal liver metastases (CRLM) is unknown. This study aimed to compare the incidence of CPR and SOxL between systemic (intravenous, IV) and HAI administration.

Methods

All patients with initially unresectable CRLM who had undergone hepatic resection in two expert centers between 2004 and 2010 after at least 6 cycles of oxaliplatin-based chemotherapy administered either via HAI (n = 18) or IV (n = 50) were included. The presence of CPR and SOxL were evaluated by two pathologists. A 1:2 case match using a propensity score was used.

Results

A CPR was observed significantly more often after HAI (33 vs. 10 %, P = 0.03). However, SOxL had occurred more frequently in patients in the HAI group versus the IV group, 66 and 20 %, respectively (P < 0.001). On a well-balanced cohort, HAI was associated with higher chance of CPR (odds ratio 9.33, 95 % confidence interval 1.59–54.7) but also higher risk of SOxL (odds ratio 13.7, 95 % confidence interval 3.08–61.3). A CPR markedly enhanced overall survival (OS) and disease-free survival (median OS of 114 vs. 42 months, P = 0.02; median disease-free survival of 51 vs. 12 months, P = 0.002). Patients with SOxL did not experience different outcome (median OS of 42 vs. 50 months, respectively; P = 0.92)

Conclusions

HAI of oxaliplatin increases the likelihood of a CPR at the cost of a higher incidence of SOxL in patients with initially unresectable CRLM.
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Metadata
Title
Comparison of Complete Pathologic Response and Hepatic Injuries Between Hepatic Arterial Infusion and Systemic Administration of Oxaliplatin in Patients with Colorectal Liver Metastases
Authors
Marc Antoine Allard, MD
Mylène Sebagh, MD
Gaëlle Baillie, MD
Antoinette Lemoine, MD, PhD
Peggy Dartigues, MD
François Faitot, MD
Matthieu Faron, MD
Valérie Boige, MD, PhD
Fabrizio Vitadello, MD
Eric Vibert, MD, PhD
Dominique Elias, MD, PhD
René Adam, MD, PhD
Diane Goéré, MD, PhD
Antonio Sa Cunha, MD
Publication date
01-06-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 6/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4272-7

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