Evaluating the effectiveness of chemotherapy before surgery for patients with colorectal cancer liver metastases.

This study evaluated the effectiveness of chemotherapy given before surgery (neoadjuvant chemotherapy; NAC) for the treatment of patients with colorectal cancer liver metastasis (CRLM) at high risk. The data showed that NAC improved the overall survival of these patients.

Colorectal cancer (CRC) is one of the most common types of cancer worldwide. The first choice for the treatment of CRC is usually surgery. In 50% of the cases, cancer spreads to the liver. This is known as colorectal cancer liver metastasis (CRLM). Less than 20% of these patients are eligible for surgery to remove the metastases. Often, these patients can be given chemotherapy before surgery (neoadjuvant chemotherapy; NAC) to shrink the cancer so that it can be completely removed by surgery. However, the effectiveness of NAC for the treatment of patients with CRLM at high risk is still unclear.

This study involved 168 patients with CRLM at high risk. Patients were divided into 2 groups. Group 1 included 112 patients who received NAC before surgery. Group 2 included 56 patients who received upfront surgery. The average follow-up time was 40 months.

After 1 year, 96.4% of the patients in group 1 were alive versus 94.4% of the patients in group 2. After 3 years, 68.5% of the patients in group 1 were alive versus 50.2% of the patients in group 2. After 5 years, 50.6% of the patients in group 1 were alive versus 35.8% of the patients in group 2. These differences were statistically significant.

After 1 year, 70.5% of the patients in group 1 were alive without cancer worsening versus 57.1% of the patients in group 2. This difference was not statistically significant.

The hospital stay after surgery was significantly shorter in patients treated by NAC. No other differences were observed in surgical outcomes between the two groups.

This study concluded that NAC improved the overall survival outcomes and reduced hospital stays in patients with CRLM at high risk.

This study looked back in time at medical records. It only included patients from a single institution in China. The sample size was very small. Larger studies are needed to validate these findings.