Comparison of oncological outcomes between neoadjuvant and adjuvant chemotherapy combined with surgery for resectable synchronous colorectal liver metastases

Abstract

BackgroundThe role of neoadjuvant chemotherapy for resectable colorectal liver metastases is a subject of debate. We compared the oncologic outcomes between neoadjuvant chemotherapy and adjuvant chemotherapy combined with surgery for resectable synchronous colorectal liver metastases. MethodsWe analyzed 30 patients who underwent liver resection for resectable colorectal liver metastases combined with oxaliplatin-based neoadjuvant or adjuvant chemotherapy between May 2003 and August 2010. We assessed recurrence-free and overall survival in patients treated using neoadjuvant chemotherapy compared with those who received adjuvant chemotherapy. ResultsOf the 30 patients with colorectal liver metastases, 15 underwent neoadjuvant chemotherapy and 15 underwent adjuvant chemotherapy. Nine (60%) patients in the adjuvant group relapsed and nine (60%) patients in the neoadjuvant group relapsed. The neoadjuvant chemotherapy group had no significant difference in recurrence-free and overall 3-y survival (37.5% versus 45.0%, P = 0.938; 44.0% versus 66.7 %, P = 0.466) compared with the adjuvant chemotherapy group. ConclusionOur results indicate that neoadjuvant chemotherapy is not inferior to adjuvant chemotherapy for resectable colorectal liver metastases, although the study was not randomized and included a limited number of patients.