Evaluating the effects on survival of chemotherapy after surgery to remove liver or lung metastases in patients with colorectal cancer

This article evaluated the effects of chemotherapy after the surgical removal of liver and lung metastases on survival in patients with colorectal cancer (CRC). 

Metastatic CRC is cancer that has spread from the large intestine to distant organs or tissues in the body. The parts of the body mainly affected by metastatic spread from CRC are the liver, closely followed by the lungs. These metastatic tumors (metastases) in the liver and lungs are removed surgically whenever possible. This may significantly improve survival in CRC patients. However, many of these patients develop recurrences (return of the cancer) after a first surgery to remove liver or lung metastases. The benefit of chemotherapy before or after this surgical treatment is not fully understood. This study aimed to evaluate whether chemotherapy after surgery (adjuvant chemotherapy) to remove liver and lung metastases improves the disease free survival or DFS (the length of time patients survived disease-free after treatment) in patients with CRC.

This study included 151 CRC patients who had successful surgery to remove liver and lung metastases. Of these participants, 78 underwent adjuvant chemotherapy within a month after the surgery and 73 had no further treatment. Chemotherapy was given for 6 months and included a variety of regimens such as those involving 5-fluorouracil, capecitabine, and combination treatments such as FOLFIRI and FOLFOX. Patients were followed up for approximately 4 years by regular physical examinations, blood and imaging tests.

Results from this study showed that patients treated with chemotherapy after successful surgical removal of liver and lungs metastases had a DFS of 16 months, compared to 9.7 months in patients who did not have chemotherapy. There was no difference in DFS for patients who received single drug chemotherapy or a combination regimen. Overall survival (the length of time patients survived with or without the disease) was an average of 42.6 months, but ranged from 6 to 120 months. There was no difference in overall survival between patients who received adjuvant chemotherapy and those who did not. 

In summary, this article showed that adjuvant chemotherapy treatment after surgical removal of liver or lung metastases from colorectal cancer can give a significant benefit to the patient, by increasing DFS. 

This study had a very small number of participants. Also, several chemotherapy regimens were used, so it was not possible to establish a formal recommendation. 

Ask your doctor what treatment is the most appropriate for your situation.