Oxaliplatin, Fluorouracil, and Leucovorin for Patients with Unresectable Liver-Only Metastases from Colorectal Cancer: A North Central Cancer Treatment Group Phase II Study.
Publication/Presentation Date
12-20-2005
Abstract
PURPOSE: Surgical resection of liver-only metastases from colorectal cancer has undergone extensive evaluation and review. The use of neoadjuvant chemotherapy to improve the likelihood of resection in disease that is not optimally resectable has not been as well studied.
PATIENTS AND METHODS: Patients with liver-only metastases from colorectal cancer deemed not optimally resectable by a surgeon with expertise in liver surgery received fluorouracil, leucovorin, and oxaliplatin (FOLFOX4). Patients were periodically reassessed for resectability. Surgical response was classified as completely resectable (S-CR), partially resectable (S-PR), or unresectable (S-UR). Study design specified the accrual of 39 patients, with two or more S-CRs considered evidence of promising activity with respect to increasing the S-CR rate.
RESULTS: Forty-two of 44 patients were assessable for this analysis. Twenty-five patients (60%) had tumor reduction by serial imaging. Seventeen patients (40%) underwent surgery (S-CR, n = 14; S-PR, n = 1; and S-UR, n = 2) after a median of 6 months of chemotherapy. With a median postsurgical follow-up of 22 months (range, 13 to 32 months), 11 recurrences have occurred in the 15 S-CR and S-PR patients. Median survival time was 26 months.
CONCLUSION: Our data suggest that FOLFOX4 has a high response rate (complete response, partial response, or reduction) in patients with liver-only metastases from colorectal cancer, allowing for successful resection of disease in a portion of patients initially not judged to be optimally resectable. However, a high recurrence rate after surgery was observed, which, in 73% of patients, involved the liver. Further trials are indicated based on the promising results observed in this trial.
Volume
23
Issue
36
First Page
9243
Last Page
9249
ISSN
0732-183X
Published In/Presented At
Alberts, S. R., Horvath, W. L., Sternfeld, W. C., Goldberg, R. M., Mahoney, M. R., Dakhil, S. R., & ... Donohue, J. H. (2005). Oxaliplatin, Fluorouracil, and Leucovorin for Patients with Unresectable Liver-Only Metastases from Colorectal Cancer: A North Central Cancer Treatment Group Phase II Study. Journal Of Clinical Oncology: Official Journal Of The American Society Of Clinical Oncology, 23(36), 9243-9249.
Disciplines
Medical Sciences | Medicine and Health Sciences
PubMedID
16230673
LVHN link
http://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=16230673&site=ehost-live&scope=site
Peer Reviewed for front end display
Peer-Reviewed
Department(s)
Department of Medicine, Hematology-Medical Oncology Division, Department of Medicine Faculty
Document Type
Article