Adjuvant oxaliplatin- or irinotecan-containing chemotherapy improves overall survival following resection of metachronous colorectal liver metastases

Jin Hwang Liu, Yao Y. Hsieh, Wei Shone Chen, Yen Ning Hsu, Gar Yang Chau, Hao W. Teng, Kuang Liang King, Tzu Chen Lin, Chen Hwai Tzeng, Jen K. Lin

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Abstract

Purpose: Adjuvant systemic 5-fluorouracil (5-FU)-based chemotherapy improves survival after resection of synchronous colorectal liver metastases (CLMs), but not metachronous. We retrospectively examined if adjuvant chemotherapy with new regimen containing oxaliplatin or irinotecan improved survivals after resection of metachronous CLMs. Methods: Between 2000 and 2007, 52 patients having undertaken resection of metachronous CLMs with curative intent were identified from Taipei Veterans General Hospital hospitalization registry. One patient with perioperative mortality and another being lost to follow-up within 3 months after metastasectomy were excluded. Thirty-one patients experienced six to 12 cycles of FOLFOX or FOLFIRI chemotherapy while 19 patients with 5-FU/leucovorin (LV)-based chemotherapy following CLM resection. The primary end point was disease-free survival (DFS) and secondary end point, overall survival (OS). Results: By the univariate analysis, median DFS was 34.3 months in the FOLFOX/FOLFIRI group vs 14.2 months in the 5-FU/LV group (P=0.022). The median OS and 5-year survival rates were longer than 57.7 months (not reached, with median follow-up of 35.5 months) and 54.0%, respectively, in the FOLFOX/FOLFIRI group compared to 49 months and 34.6% in the 5-FU/LV group (P=0.027). FOLFOX/FOLFIRI chemotherapy was shown by multivariate analyses to be an independent factor predicting a better DFS (hazard ratio [HR]=0.37; 95% CI: 0.15-0.94; P=0.036) and a better OS (HR=0.27; 95% CI: 0.083-0.86, P=0.026) than 5-FU/LV-based. Conclusions: Adjuvant FOLFOX/FOLFIRI chemotherapy following resection of metachronous CLMs is demonstrated to have better DFS and OS than 5-FU/LV chemotherapy.

Original languageEnglish
Pages (from-to)1243-1249
Number of pages7
JournalInternational Journal of Colorectal Disease
Volume25
Issue number10
DOIs
Publication statusPublished - Oct 2010
Externally publishedYes

Fingerprint

irinotecan
oxaliplatin
Leucovorin
Fluorouracil
Neoplasm Metastasis
Drug Therapy
Disease-Free Survival
Survival
Liver
Metastasectomy
Veterans Hospitals
Lost to Follow-Up
Adjuvant Chemotherapy
General Hospitals
Registries
Hospitalization
Multivariate Analysis
Survival Rate

Keywords

  • Adjuvant chemotherapy
  • Colorectal liver metastasis
  • Irinotecan
  • Metachronous
  • Oxaliplatin

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Adjuvant oxaliplatin- or irinotecan-containing chemotherapy improves overall survival following resection of metachronous colorectal liver metastases. / Liu, Jin Hwang; Hsieh, Yao Y.; Chen, Wei Shone; Hsu, Yen Ning; Chau, Gar Yang; Teng, Hao W.; King, Kuang Liang; Lin, Tzu Chen; Tzeng, Chen Hwai; Lin, Jen K.

In: International Journal of Colorectal Disease, Vol. 25, No. 10, 10.2010, p. 1243-1249.

Research output: Contribution to journalArticle

Liu, Jin Hwang ; Hsieh, Yao Y. ; Chen, Wei Shone ; Hsu, Yen Ning ; Chau, Gar Yang ; Teng, Hao W. ; King, Kuang Liang ; Lin, Tzu Chen ; Tzeng, Chen Hwai ; Lin, Jen K. / Adjuvant oxaliplatin- or irinotecan-containing chemotherapy improves overall survival following resection of metachronous colorectal liver metastases. In: International Journal of Colorectal Disease. 2010 ; Vol. 25, No. 10. pp. 1243-1249.
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title = "Adjuvant oxaliplatin- or irinotecan-containing chemotherapy improves overall survival following resection of metachronous colorectal liver metastases",
abstract = "Purpose: Adjuvant systemic 5-fluorouracil (5-FU)-based chemotherapy improves survival after resection of synchronous colorectal liver metastases (CLMs), but not metachronous. We retrospectively examined if adjuvant chemotherapy with new regimen containing oxaliplatin or irinotecan improved survivals after resection of metachronous CLMs. Methods: Between 2000 and 2007, 52 patients having undertaken resection of metachronous CLMs with curative intent were identified from Taipei Veterans General Hospital hospitalization registry. One patient with perioperative mortality and another being lost to follow-up within 3 months after metastasectomy were excluded. Thirty-one patients experienced six to 12 cycles of FOLFOX or FOLFIRI chemotherapy while 19 patients with 5-FU/leucovorin (LV)-based chemotherapy following CLM resection. The primary end point was disease-free survival (DFS) and secondary end point, overall survival (OS). Results: By the univariate analysis, median DFS was 34.3 months in the FOLFOX/FOLFIRI group vs 14.2 months in the 5-FU/LV group (P=0.022). The median OS and 5-year survival rates were longer than 57.7 months (not reached, with median follow-up of 35.5 months) and 54.0{\%}, respectively, in the FOLFOX/FOLFIRI group compared to 49 months and 34.6{\%} in the 5-FU/LV group (P=0.027). FOLFOX/FOLFIRI chemotherapy was shown by multivariate analyses to be an independent factor predicting a better DFS (hazard ratio [HR]=0.37; 95{\%} CI: 0.15-0.94; P=0.036) and a better OS (HR=0.27; 95{\%} CI: 0.083-0.86, P=0.026) than 5-FU/LV-based. Conclusions: Adjuvant FOLFOX/FOLFIRI chemotherapy following resection of metachronous CLMs is demonstrated to have better DFS and OS than 5-FU/LV chemotherapy.",
keywords = "Adjuvant chemotherapy, Colorectal liver metastasis, Irinotecan, Metachronous, Oxaliplatin",
author = "Liu, {Jin Hwang} and Hsieh, {Yao Y.} and Chen, {Wei Shone} and Hsu, {Yen Ning} and Chau, {Gar Yang} and Teng, {Hao W.} and King, {Kuang Liang} and Lin, {Tzu Chen} and Tzeng, {Chen Hwai} and Lin, {Jen K.}",
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T1 - Adjuvant oxaliplatin- or irinotecan-containing chemotherapy improves overall survival following resection of metachronous colorectal liver metastases

AU - Liu, Jin Hwang

AU - Hsieh, Yao Y.

AU - Chen, Wei Shone

AU - Hsu, Yen Ning

AU - Chau, Gar Yang

AU - Teng, Hao W.

AU - King, Kuang Liang

AU - Lin, Tzu Chen

AU - Tzeng, Chen Hwai

AU - Lin, Jen K.

PY - 2010/10

Y1 - 2010/10

N2 - Purpose: Adjuvant systemic 5-fluorouracil (5-FU)-based chemotherapy improves survival after resection of synchronous colorectal liver metastases (CLMs), but not metachronous. We retrospectively examined if adjuvant chemotherapy with new regimen containing oxaliplatin or irinotecan improved survivals after resection of metachronous CLMs. Methods: Between 2000 and 2007, 52 patients having undertaken resection of metachronous CLMs with curative intent were identified from Taipei Veterans General Hospital hospitalization registry. One patient with perioperative mortality and another being lost to follow-up within 3 months after metastasectomy were excluded. Thirty-one patients experienced six to 12 cycles of FOLFOX or FOLFIRI chemotherapy while 19 patients with 5-FU/leucovorin (LV)-based chemotherapy following CLM resection. The primary end point was disease-free survival (DFS) and secondary end point, overall survival (OS). Results: By the univariate analysis, median DFS was 34.3 months in the FOLFOX/FOLFIRI group vs 14.2 months in the 5-FU/LV group (P=0.022). The median OS and 5-year survival rates were longer than 57.7 months (not reached, with median follow-up of 35.5 months) and 54.0%, respectively, in the FOLFOX/FOLFIRI group compared to 49 months and 34.6% in the 5-FU/LV group (P=0.027). FOLFOX/FOLFIRI chemotherapy was shown by multivariate analyses to be an independent factor predicting a better DFS (hazard ratio [HR]=0.37; 95% CI: 0.15-0.94; P=0.036) and a better OS (HR=0.27; 95% CI: 0.083-0.86, P=0.026) than 5-FU/LV-based. Conclusions: Adjuvant FOLFOX/FOLFIRI chemotherapy following resection of metachronous CLMs is demonstrated to have better DFS and OS than 5-FU/LV chemotherapy.

AB - Purpose: Adjuvant systemic 5-fluorouracil (5-FU)-based chemotherapy improves survival after resection of synchronous colorectal liver metastases (CLMs), but not metachronous. We retrospectively examined if adjuvant chemotherapy with new regimen containing oxaliplatin or irinotecan improved survivals after resection of metachronous CLMs. Methods: Between 2000 and 2007, 52 patients having undertaken resection of metachronous CLMs with curative intent were identified from Taipei Veterans General Hospital hospitalization registry. One patient with perioperative mortality and another being lost to follow-up within 3 months after metastasectomy were excluded. Thirty-one patients experienced six to 12 cycles of FOLFOX or FOLFIRI chemotherapy while 19 patients with 5-FU/leucovorin (LV)-based chemotherapy following CLM resection. The primary end point was disease-free survival (DFS) and secondary end point, overall survival (OS). Results: By the univariate analysis, median DFS was 34.3 months in the FOLFOX/FOLFIRI group vs 14.2 months in the 5-FU/LV group (P=0.022). The median OS and 5-year survival rates were longer than 57.7 months (not reached, with median follow-up of 35.5 months) and 54.0%, respectively, in the FOLFOX/FOLFIRI group compared to 49 months and 34.6% in the 5-FU/LV group (P=0.027). FOLFOX/FOLFIRI chemotherapy was shown by multivariate analyses to be an independent factor predicting a better DFS (hazard ratio [HR]=0.37; 95% CI: 0.15-0.94; P=0.036) and a better OS (HR=0.27; 95% CI: 0.083-0.86, P=0.026) than 5-FU/LV-based. Conclusions: Adjuvant FOLFOX/FOLFIRI chemotherapy following resection of metachronous CLMs is demonstrated to have better DFS and OS than 5-FU/LV chemotherapy.

KW - Adjuvant chemotherapy

KW - Colorectal liver metastasis

KW - Irinotecan

KW - Metachronous

KW - Oxaliplatin

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