Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 18 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Chemotherapy with surgery improves colorectal cancer outcomes

This week's The Lancet examines perioperative chemotherapy with surgery vs surgery alone for resectable liver metastases from colorectal cancer.

News image

fiogf49gjkf04

Surgical resection alone is regarded as the standard of care for patients with liver metastases from colorectal cancer, but relapse is common.

Professor Bernard Nordlinger and colleagues from France assessed the combination of perioperative chemotherapy and surgery compared with surgery alone for patients with initially resectable liver metastases from colorectal cancer.

Progression-free survival at 3 years increased by 9% in patients undergoing resection
The Lancet

The investigators conducted a parallel-group study.

The team report the trial's final data for progression-free survival for a protocol unspecified interim time-point, while overall survival is still being monitored.

The investigators randomized 364 patients with histologically proven colorectal cancer and up to 4 liver metastases to either 6 cycles of FOLFOX4 before, and 6 cycles after surgery or to surgery alone.

There were 182 in the perioperative chemotherapy group vs 182 in the surgery group.

The primary objective was to detect a hazard ratio of 0.7 or less for progression-free survival.

Primary analysis was by intention to treat.

The team repeated analyses for all eligible, and resected patients.

The investigators found in the perioperative chemotherapy group, 83% were resected after a median of 6 preoperative cycles, and 63% received a median of 6 postoperative cycles.

The team reported that 84% of patients were resected in the surgery group.

The absolute increase in rate of progression-free survival at 3 years was 7%, from 28% to 35% in randomized patients.

Progression-free survival at 3 years increased by 8%, from 28% to 36% in eligible patients, and 9%, from 33% to 42% in patients undergoing resection.

The investigators noted that 139 patients died, of which 64 were in the perioperative chemotherapy group vs 75 in the surgery group.

The team found reversible postoperative complications occurred more often after chemotherapy than after surgery.

The investigators found 2 deaths in the surgery alone group, and 1 in the perioperative chemotherapy group.

Professor Nordlinger's team concluded, "Perioperative chemotherapy with FOLFOX4 is compatible with major liver surgery, and reduces the risk of events of progression-free survival in eligible and resected patients."

The Lancet 2008: 371(9617): 1007-16
26 March 2008

Go to top of page Email this page Email this page to a colleague

 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Management of hemorrhoids in the USA
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis
 26 January 2018 
Optimizing selection of biologics in IBD
 26 January 2018 
Nutritional risk and laparoscopic-assisted gastrectomy outcomes
 25 January 2018 
Patient-reported outcome measure for functional dyspepsia
 25 January 2018 
Predicting intra-abdominal infections after colorectal surgery
 25 January 2018 
Predictors of gastric cancer risk
 24 January 2018 
Risk factors underlying previously undiagnosed cirrhosis
 24 January 2018 
Ethnicity influences phenotype in IBD
 24 January 2018 
Bariatric surgery vs medical obesity treatment
 23 January 2018 
Atrophic gastritis after H. pylori eradication
 23 January 2018 
Ectopic pregnancy in women with IBD
 23 January 2018 
Celiac disease in IBS in the USA
 22 January 2018 
Improving symptoms in GERD
 22 January 2018 
Costs of biologic therapies for IBD in the USA
 22 January 2018 
Western vs Asian guidelines for colon cancer management

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us