In this study, researchers from France, retrospectively assessed the safety, efficacy, and long-term results of neoadjuvant chemotherapy and cryotherapy, as additional means of eradicating liver metastases from colorectal carcinoma.
The team examined 131 patients with unresectable liver metastases, between 1996 and 1997.
These patients were referred to the team's department and received chemotherapy.
|In the cryotherapy plus resection group, neoadjuvant chemotherapy resulted in 13 partial responses, 9 stable diseases, and 2 disease progressions.|
After 3 to 6 months of chemotherapy, curative surgery of liver metastases was considered possible in 57 patients. By resection alone in 25% or by cryotherapy associated with resection in 18%.
The team then compared characteristics and survival of patients in the cryotherapy plus resection group with 33 patients in the resection-only group.
The research team found that all patients in the resection group had a partial response to neoadjuvant chemotherapy.
However, 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%, and the team found no major difference between the 2 patient groups.
After a median follow-up of 48 months, the team determined median survival to be 39 months.
They team found survival rates at 1, 3, and 4 years were similar in both groups.
These were 94%, 58%, and 37% in the resection group and 92%, 50%, and 36% in the cryotherapy plus resection group, respectively.
Dr Michel Rivoire's team concluded, "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".