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

This study evaluated the effectiveness of chemotherapy before surgery for the treatment of patients with resectable colorectal cancer liver metastasis (CRLM). The data showed that the addition of chemotherapy before surgery significantly improved disease-free survival (survival without any signs or symptoms of cancer) but not the overall survival in 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 known as CRC liver metastasis. Less than 20% of these patients are eligible for surgery to remove the metastases. Often, these patients are given chemotherapy after surgery to shrink/destroy the liver metastases.

Sometimes, chemotherapy is given also before surgery in order to shrink the tumor. However, the effectiveness of chemotherapy given before, during, or after surgery for the treatment of patients with resectable CRLM is still unclear.

This study analyzed 7 other studies and involved 1504 patients with CRLM. 6 studies involved chemotherapy given after surgery and 1 study evaluated chemotherapy given before and after surgery. Fluoropyrimidine-based chemotherapy such as fluorouracil (Adrucil), and capecitabine (Xeloda) was the most used chemotherapy.

Patients who received chemotherapy before, during, or after surgery were 27% more likely to survive without any signs or symptoms of cancer (disease-free) compared to patients who received surgery alone. This was statistically significant.

Patients who received chemotherapy before, during, or after surgery were 12% more likely to have a better overall survival compared to patients who received surgery alone. This was not considered to be statistically significant.

This study concluded that the addition of chemotherapy before and after surgery significantly improved disease-free survival but not the overall survival in patients with CRLM.

This study looked back in time at medical records. The sample size was very small. This study analyzed studies that did not compare the therapies directly.