PMID- 27317952
OWN - NLM
STAT- MEDLINE
DCOM- 20171116
LR  - 20220318
IS  - 1477-2574 (Electronic)
IS  - 1365-182X (Print)
IS  - 1365-182X (Linking)
VI  - 18
IP  - 6
DP  - 2016 Jun
TI  - Systematic review of systemic adjuvant, neoadjuvant and perioperative 
      chemotherapy for resectable colorectal-liver metastases.
PG  - 485-93
LID - S1365-182X(16)30016-8 [pii]
LID - 10.1016/j.hpb.2016.03.001 [doi]
AB  - INTRODUCTION: The role of systemic chemotherapy in patients with resectable 
      colorectal liver metastases (CRLM) is ambiguous. The aim of this review was to 
      compare the outcomes of regimens using systemic neoadjuvant, adjuvant or 
      perioperative (combination of pre and postoperative) chemotherapy, for the 
      treatment of resectable CRLM. METHODS: MEDLINE was searched for articles 
      investigating the use of chemotherapy for adults with resectable CRLM. Randomized 
      controlled trials reporting overall survival (OS), disease-free survival (DFS) 
      and grade 3-4 adverse events (AEs) were screened for inclusion. PROSPERO record: 
      CRD42015020609. RESULTS: Four trials met the inclusion criteria (1098 patients). 
      No significant improvement in median OS was achieved with chemotherapy/surgery 
      compared with surgery-alone. Two trials demonstrated a significant improvement in 
      DFS with chemotherapy/surgery compared to surgery-alone (Hazard ratio 0.78 
      (0.61-0.99) p = 0.04 and HR 0.66 (0.46-0.96) p = 0.03). Fluorouracil/folinic acid 
      alone had a lower incidence of AEs than combination therapies, and the addition 
      of cetuximab shortened DFS in one trial (HR 1.48 (1.04-2.12) p = 0.03). 
      CONCLUSION: There is a lack of adequately powered trials of chemotherapy in 
      combination with liver resection for CRLM, partly due to difficulties in 
      recruitment. In an unselected patient group, FOLFOX in combination with liver 
      resection appears to improve DFS compared to surgery-alone, but trials are 
      underpowered for OS. Future trials will require prospective stratification of 
      patients based on biomarkers predictive of response.
CI  - Copyright (c) 2016 International Hepato-Pancreato-Biliary Association Inc. 
      Published by Elsevier Ltd. All rights reserved.
FAU - Khoo, Emily
AU  - Khoo E
AD  - Department of Clinical Surgery, University of Edinburgh, Royal Infirmary of 
      Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
FAU - O'Neill, Stephen
AU  - O'Neill S
AD  - Department of Clinical Surgery, University of Edinburgh, Royal Infirmary of 
      Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
FAU - Brown, Ewan
AU  - Brown E
AD  - Edinburgh Cancer Centre, University of Edinburgh, Western General Hospital, Crewe 
      Road South, Edinburgh EH4 2XR, UK.
FAU - Wigmore, Stephen J
AU  - Wigmore SJ
AD  - Department of Clinical Surgery, University of Edinburgh, Royal Infirmary of 
      Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
FAU - Harrison, Ewen M
AU  - Harrison EM
AD  - Department of Clinical Surgery, University of Edinburgh, Royal Infirmary of 
      Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK. Electronic address: 
      ewen.harrison@ed.ac.uk.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20160420
PL  - England
TA  - HPB (Oxford)
JT  - HPB : the official journal of the International Hepato Pancreato Biliary 
      Association
JID - 100900921
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Chemotherapy, Adjuvant
MH  - Colorectal Neoplasms/mortality/*pathology
MH  - Disease Progression
MH  - Disease-Free Survival
MH  - Female
MH  - *Hepatectomy/adverse effects/mortality
MH  - Humans
MH  - Liver Neoplasms/mortality/*secondary/*therapy
MH  - Male
MH  - Middle Aged
MH  - *Neoadjuvant Therapy/adverse effects/mortality
MH  - Neoplasm Recurrence, Local
MH  - Risk Factors
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC4913134
EDAT- 2016/06/19 06:00
MHDA- 2017/11/29 06:00
PMCR- 2016/04/20
CRDT- 2016/06/19 06:00
PHST- 2016/02/24 00:00 [received]
PHST- 2016/03/02 00:00 [accepted]
PHST- 2016/06/19 06:00 [entrez]
PHST- 2016/06/19 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/04/20 00:00 [pmc-release]
AID - S1365-182X(16)30016-8 [pii]
AID - 10.1016/j.hpb.2016.03.001 [doi]
PST - ppublish
SO  - HPB (Oxford). 2016 Jun;18(6):485-93. doi: 10.1016/j.hpb.2016.03.001. Epub 2016 
      Apr 20.