Is adjuvant systemic chemotherapy after resection of metastases from colorectal cancer suitable?

Abstract

3654 Background: In patients affected by metastatic colorectal cancer surgical resection of metastases improves the overall survival (OS) and represents the only potentially curative therapy in spite of the high 2 years-recurrence rate of disease. Adjuvant chemotherapy via hepatic arterial infusion (HAI) after resection of liver metastases has shown its efficacy in terms of disease free survival (DFS) but not for OS. On the contrary, the role of adjuvant systemic chemotherapy after metastases resection (ASCMR) was rarely investigated in randomised trials. This retrospective analysis has considered the role of ASCMR on DFS in patients submitted to radical resection of lung or liver metastases (synchronous or metachronous at first recurrence) from colorectal cancer between June 1996 and January 2003 in our centre. Methods: 48 patients were eligible; 32 received ASCMR (M19; F 13) and 16 did not receive any therapy (M 8; F 8). ASCMR used regimens were: 9 pts Mayo clinic (mean number of infusion 6,2 range 3–12); 10 pts Folfox-4 (6,2 range 3–11); 4 pts Folfiri (6,5 range 5–9); 9 pts De Gramont (6,5 range 6–10).The characteristics of patients and lesions are reported in Tab 1 Results: Results are reported in Tab 1 Conclusions: The features of the disease in the two groups of patients (treated with ASCMR and not) are not different. DFS is statistically higher for patients submitted to ASCMR (in particular for lung metastases). In conclusions the adjuvant systemic chemotherapy after resection of metastases from colorectal cancer could prolong DFS, but large prospective studies are needed to define overall survival. No significant financial relationships to disclose.