Conversion chemotherapy followed by hepatic resection in colorectal cancer with initially unresectable liver-limited metastases

  • Authors:
    • Gennaro Galizia
    • Ferdinando De Vita
    • Eva Lieto
    • Anna Zamboli
    • Floriana Morgillo
    • Paolo Castellano
    • Andrea Mabilia
    • Annamaria Auricchio
    • Andrea Renda
    • Fortunato Ciardiello
    • Michele Orditura
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  • Published online on: October 11, 2013     https://doi.org/10.3892/or.2013.2795
  • Pages: 2992-2998
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Abstract

The best management choice in colorectal cancer patients with unresectable liver-only metastases should be represented by conversion chemotherapy aiming to reduce liver cancer deposits, thereby permitting curative surgery. Forty‑eight consecutive stage IV colorectal cancer patients were treated with different chemotherapeutic regimens including biological drugs. Objective responses to chemotherapy were seen in 27 patients (56.2%; 95% CI 42.1-70.2%). Four patients (8.3%) showed complete response, 23 patients (47.9%) partial and 13 patients (27.1%) stable response. Eight patients (16.7%) progressed. The conversion rate was 35.4% (95% CI 21.8-48.9%) with 17 patients suitable for liver resection. Four complete responder patients refused surgery. The remaining 13 patients underwent curative hepatic resection (resection rate 27.1%; 95% CI 14.5-39.6%). The likelihood of a successful conversion chemotherapy appeared significantly related to the best response and to the K-Ras status. Wild-type K-Ras patients undergoing cetuximab therapy showed the best conversion rate. The four-year survival rate was significantly enhanced in converted compared to non-converted patients (57.1 and 0%, respectively), and in resected compared to non‑resected patients (53.3 and 10.1%, respectively). Synchronous metastases and no conversion were shown to be the only covariates independently associated with a poorer long-term outcome. The possibility of curative liver surgery significantly prolongs outcome for colorectal cancer patients with unresectable liver‑limited metastases. Prospective randomized trials are required to define the conversion rates with biological drugs.
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December 2013
Volume 30 Issue 6

Print ISSN: 1021-335X
Online ISSN:1791-2431

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Spandidos Publications style
Galizia G, De Vita F, Lieto E, Zamboli A, Morgillo F, Castellano P, Mabilia A, Auricchio A, Renda A, Ciardiello F, Ciardiello F, et al: Conversion chemotherapy followed by hepatic resection in colorectal cancer with initially unresectable liver-limited metastases. Oncol Rep 30: 2992-2998, 2013.
APA
Galizia, G., De Vita, F., Lieto, E., Zamboli, A., Morgillo, F., Castellano, P. ... Orditura, M. (2013). Conversion chemotherapy followed by hepatic resection in colorectal cancer with initially unresectable liver-limited metastases. Oncology Reports, 30, 2992-2998. https://doi.org/10.3892/or.2013.2795
MLA
Galizia, G., De Vita, F., Lieto, E., Zamboli, A., Morgillo, F., Castellano, P., Mabilia, A., Auricchio, A., Renda, A., Ciardiello, F., Orditura, M."Conversion chemotherapy followed by hepatic resection in colorectal cancer with initially unresectable liver-limited metastases". Oncology Reports 30.6 (2013): 2992-2998.
Chicago
Galizia, G., De Vita, F., Lieto, E., Zamboli, A., Morgillo, F., Castellano, P., Mabilia, A., Auricchio, A., Renda, A., Ciardiello, F., Orditura, M."Conversion chemotherapy followed by hepatic resection in colorectal cancer with initially unresectable liver-limited metastases". Oncology Reports 30, no. 6 (2013): 2992-2998. https://doi.org/10.3892/or.2013.2795