Feasibility and short-term outcome of adjuvant FOLFOX after resection of colorectal liver metastases.
Level 4 - case-series / case-control
Single-center case series without an internal control group.
PubMed 22610308 · doi:10.1007/s00534-012-0523-9
What was done
The study assessed the feasibility and survival outcomes of adjuvant chemotherapy (FOLFOX4 or modified FOLFOX6) in 24 patients who underwent liver resection for colorectal liver metastases between 2005 and 2010 at Kumamoto University, selected from a total cohort of 86 resected patients.
What was found
Twenty-one of 24 patients (87.5%) completed 6 cycles of adjuvant chemotherapy. Dose reductions occurred in 5 patients due to neutropenia, with relative dose intensities of 93.6% for oxaliplatin and 94.1% for 5-fluorouracil, and no severe adverse events were reported. Over a median follow-up of 48.4 months, 12 patients had disease recurrence and 3 died. The 3- and 5-year disease-free survival rates were 51.6% and 45.1%, and 3- and 5-year overall survival rates were 95.5% and 76.0%, respectively.
Why it matters
This report indicates that adjuvant FOLFOX is clinically feasible with high completion and dose intensity following hepatic resection for colorectal liver metastases.
Limits
The study is constrained by a very small sample size (n = 24), a single-center design, and the absence of a control group (such as surgery alone). Selection criteria explaining why only 24 of 86 resected patients received adjuvant FOLFOX were not detailed in the abstract.
Cited by
- contradicts Patients with stage III colon cancer treated with surgical resection and the 3-drug FOLFOX chemotherapy regimen have a 65% 5-year survival rate, whereas stage IV colon cancer patients with visible liver metastases have a 0% 5-year survival rate after the same chemotherapy.