Peri-operative chemotherapy for the treatment of resectable liver metastases from colorectal cancer: A systematic review and meta-analysis of randomized trialsReportar como inadecuado




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BMC Cancer

, 10:309

Clinical oncology

Abstract

BackgroundThe role of peri-operative chemotherapy in patients with resected stage IV colorectal cancer CRC remains to be defined. This study was aimed at evaluating the effectiveness of peri-operative chemotherapy in patients with resected stage IV CRC by performing a meta-analysis of relevant trials.

MethodsWe performed a literature search to identify trials comparing patients with stage IV CRC receiving peri-operative chemotherapy and surgery with patients undergoing surgery alone. The hazard ratio HR was estimated to assess any survival advantage of peri-operative chemotherapy.

ResultsEight trials conducted on a total of 1174 patients were identified by a literature search. In these trials, HR estimates suggested that peri-operative chemotherapy yielded no survival advantage over surgery alone HR, 0.94; 95%CI, 0.8-1.10; p = 0.43. In a subset analysis on intra-arterial chemotherapy alone, no survival benefit was evident HR, 1.0; 95% CI, 0.84-1.21; p = 0.96; I = 30%, whereas in the trials involving systemic chemotherapy, the difference between the groups approached statistical significance HR, 0.74; 95% CI, 0.53-1.04; p = 0.08; I = 0%. Both peri-operative treatment groups had a significant recurrence-free survival benefit HR, 0.78; 95% CI, 0.65-0.95; P = 0.01 for hepatic arterial infusion; and HR, 0.75; 95% CI, 0.62-0.91; p = 0.003 for systemic therapy. The toxicities of chemotherapy were acceptable in most trials.

ConclusionsThis is the first meta-analysis demonstrating the importance of peri-operative chemotherapy in the treatment of resected stage IV CRC. Although the results must be carefully interpreted because of some limitations, critical issues were identified that must be resolved by future studies.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-10-309 contains supplementary material, which is available to authorized users.

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Autor: Martina Wieser - Stefan Sauerland - Dirk Arnold - Wolff Schmiegel - Anke Reinacher-Schick

Fuente: https://link.springer.com/







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