Does adding chemotherapy after surgery for liver metastasis improve the long-term outcome of patients with colorectal cancer?

The study investigated the impact of adding chemotherapy after surgery to remove liver metastasis on the outcomes of patients with colorectal cancer (CRC). The study reported a significantly longer survival in patients undergoing further chemotherapy.

Up to 50% of patients with CRC develop metastasis (cancer spread to distant organs). Most of these metastases occur in the liver. Some patients benefit from surgery to remove these metastases. However, many patients have liver metastases reappear after previous tumors had been removed from the liver. These are called metachronous colorectal liver metastasis (MCRLM).

Some studies suggested that adding chemotherapy after the surgical removal of liver metastases may prevent the appearance of MCRLM. However, due to a lack of consistent data, the treatment guidelines on additive chemotherapy after liver surgery are not uniform. The impact of additive chemotherapy after surgery to remove liver metastases on the outcomes of patients with CRC remains unclear.

The study had 75 patients with CRC and liver metastases. Patients had surgery to remove liver tumors. Within 3 months after the tumor removal surgery, 34 patients received further chemotherapy. The rest of the patients did not undergo any further therapy. Patients were followed up for up to 10 years.

The addition of chemotherapy resulted in longer disease-free survival (29 months vs 18 months) and overall survival (62 months vs 57 months). After 10 years, 42% of the patients that received further chemotherapy were alive compared to 0% in the group that did not have chemotherapy. 

The study concluded that adding chemotherapy after surgery to remove liver metastases improved the outcomes of patients with CRC.

The study was done at only one site in Germany. Therefore, the results may not be applied to a bigger population. Also, the study included medical records data. Some information such as patients' other medical conditions was not available. This may impact the study results.