Abstract
BackgroundAlthough liver resection (LR) provides the best chance of long-term survival for patients with colorectal cancer (CRC) hepatic metastasis, concerns regarding chemotherapy before liver resection remain unresolved.MethodsA retrospective review of patients who underwent curative LR for CRC hepatic metastasis between January 2008 and February 2016 was performed. Outcome relevance based on oncologic prognostic factors and chemotherapy prior to liver resection was assessed.ResultsPatients who had received pre-hepatectomy chemotherapy for CRC hepatic metastasis and delayed liver resection had a worse outcome in terms of CRC recurrence following liver resection. The hazard ratio (HR) of pre-hepatectomy chemotherapy in patients with minor oncologic prognostic factors was 1.55 (confidence interval, CI = 1.07–2.26, p = 0.021) for CRC recurrence after liver resection for hepatic metastasis, whereas the HR of pre-hepatectomy chemotherapy was 1.34 (CI = 0.99–1.81, p = 0.062) for CRC recurrence in patients with multiple oncologic prognostic factors.ConclusionThe administration of pre-hepatectomy chemotherapy and delaying liver resection seems not to be an optimal strategy to provide a clinical benefit for patients with CRC hepatic metastasis. Hence, liver resection should be attempted without delay at the initial detection of CRC hepatic metastasis whenever possible.
Highlights
Liver resection (LR) provides the best chance of long-term survival for patients with colorectal cancer (CRC) hepatic metastasis, concerns regarding chemotherapy before liver resection remain unresolved
We found that waiting to administer chemotherapy before liver resection and delaying liver resection for CRC hepatic metastasis is not an optimal strategy, nor does it offer a clinical benefit to patients
In summary, patients with multiple oncologic risk factors are certainly embracing a higher risk of CRC recurrence after liver resection as compared with other patients
Summary
Liver resection (LR) provides the best chance of long-term survival for patients with colorectal cancer (CRC) hepatic metastasis, concerns regarding chemotherapy before liver resection remain unresolved. It is estimated that up to 50% of CRC patients encounter hepatic metastasis during their disease course [2, 3]. Among those patients, 20–35% of CRC recurrence after liver resection for metastases remains a great concern, and the reported. The purpose of this study was to review our experience with liver resection for patients with hepatic metastasis from CRC and to analyze patients’ outcomes based on the relevance of oncologic prognostic factors and neoadjuvant chemotherapy prior to liver resection
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