Complete resection of liver metastases of colorectal origin is the only potentially curative treatment.
In order to decrease recurrences, the use of adjuvant systemic chemotherapy after liver resection is controversial because no trial has demonstrated its benefit.
Dr Guillaume Portier and colleagues from France conducted a multicenter trial in patients with colorectal cancer.
The research team randomly assigned 173 patients with completely resected hepatic metastases from colorectal cancer to surgery alone.
A further 87 patients were randomized to observation or to surgery.
These patients were followed by 6 months of systemic adjuvant chemotherapy with a fluorouracil and folinic acid monthly regimen.
|The 5-year disease-free survival rate was 34% with chemotherapy|
|Journal of Clinical Oncology|
The researchers' main outcome criterion was disease-free survival.
Secondary outcome measures were overall survival and treatment-related toxicity.
The intention-to-treat analysis was based on 171 patients, after a median follow-up of 87 months.
The researchers found that the 5-year disease-free survival rate, after adjustment for major prognostic factors, was 34% for patients in the chemotherapy group.
The 5-year disease-free survival rate was 27% for patients in the control group.
With regard to secondary outcome measures, the team observed a trend towards increased overall survival, but this did not reach statistical significance.
Dr Portier's team concludes, “Despite a suboptimal regimen, which was the standard at the beginning of the study, adjuvant intravenous systemic chemotherapy provided a significant disease-free survival benefit for patients with resected liver metastases from colorectal cancer.”