Resection of Colorectal Liver Metastases Ups Survival

Two-stage resection after chemo results in positive outcome compared to nonsurgical treatment

THURSDAY, Jan. 27 (HealthDay News) -- Two-stage resection (TSR) is associated with good outcomes for patients with advanced colorectal liver metastases (CLM) compared to those treated nonsurgically, according to a study published online Jan. 24 in the Journal of Clinical Oncology.

Antoine Brouquet, M.D., from the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues analyzed data from 890 patients undergoing resection after chemotherapy and 879 patients who received only chemotherapy for CLM. Intent-to-treat analysis was used to evaluate survival of patients who underwent TSR. The nonsurgically treated controls were selected to match the TSR population: colorectal metastases with liver-only disease, objective response to chemotherapy, and survival for at least one year after initiation of chemotherapy.

The investigators identified 65 patients who underwent the first stage of TSR, whose outcomes were compared with 62 patients who were included in the nonsurgical group. Of the patients who completed the first stage of TSR, 47 patients went on to complete the second stage. After an average follow-up of 50 months, the five-year survival rate was 51 percent in the TSR group, compared with 15 percent in the nonsurgical group. Noncompletion and major postoperative complications were both independently associated with poorer survival in patients who underwent TSR.

"This study showed that complete TSR is associated with excellent outcome in patients with advanced bilateral CLM who respond to chemotherapy," the authors write.

Several of the study authors disclosed financial relationships with the pharmaceutical industry.

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