Indication of Neoadjuvant Chemotherapy for Patients with Colorectal Cancer Liver Metastases in our Hospital

Abstract

Background: Whether neoadjuvant chemotherapy (NAC) is approriate for the patients with initially resectable colorectal cancer liver metastases (CRLM) remains controversial. The indication of NAC was examined at the surgical meeting in our hospital. The aim of this study is to retrospectively validate our indication of NAC. Patients and Methods: From 2009 to 2019, 84 patients underwent hepatectomy for CRLM. They were divided into two groups: synchronous CRLM (SM-group n=56) and metachronous CRLM (MM-group n=28) and the indication of NAC was validated. Additionally, long-term outcomes were compared between patients who received NAC (NAC(+)-patients) and those didn´t receive NAC (NAC(-)-patients). Results: NAC was performed in 41 patients (73.3%) in SM-group and 12 patients (42.9%) in MM-group. In SM-group (28 single metastasis (sgl-Met) and 28 multiple metastases (multi-Met) ), the patients with multi-Met significantly received NAC (57.1% in sgl-Met vs. 89.3% in multi-Met, p=0.01). In MM-group (15 sgl-Met and 13 multi-Met), the period from excision of the primary cancer to the development of liver metastasis was tended to be shorter in NAC(+)-patients than NAC(-)-patients (NAC (+) 309 days vs. NAC (-) 656 days, median, p=0.09). In SM-group, there was no significant difference of 5-year OS between NAC(+)-patients and NAC(-)-patients(NAC (+) 63.6% vs. NAC (-) 74.6%, p=0.93). In MM-group, there was no significant difference between NAC(+)-patients and NAC(-)-patients(90.9% vs. 82.1%, p=0.40). Conclusion: NAC for CRLM tended to be performed to the patients with multiple- synchronous-metastasis and metachronous-metastases developing within 1year after excision of the primary cancer. According to our strategy, long-term outcomes were favorable.