Influence of neoadjuvant chemotherapy on resection of primary colorectal liver metastases: A propensity score analysis. Issue 2 (13th April 2017)

• Record Type: Journal Article
• Authors: Strowitzki, Moritz J.; Schmidt, Thomas; Keppler, Ulrich; Ritter, Alina S.; Mahmoud, Sarah; Klose, Johannes; Mihaljevic, André L.; Schneider, Martin; Büchler, Markus W.; Ulrich, Alexis B.
• Is Part Of: Journal of surgical oncology. Volume 116:Issue 2(2017)
• Page Start: 149
• Page End: 158
• Publication Date: 2017-04-13
• Subjects: colorectal cancer -- liver -- propensity score matching -- survival analysis; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24631
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract : Background and Objectives: There is ongoing debate about whether patients planned for liver resection of colorectal liver metastases (CRLM) benefit from neoadjuvant chemotherapy (NC). Therefore, we performed a retrospective survival analysis of patients with and without NC prior to surgery. Methods: Data prospectively collected from 468 consecutive patients were analyzed in a retrospective design. We performed a survival analysis and added propensity score matching (PSM). Univariate and multivariate analysis was performed to determine independent prognostic risk factors. Results: NC was performed in 145/468 patients. NC did not have a significant influence on overall survival (OS) either before or after PSM. Patients receiving NC showed increased complication rates, especially concerning non‐surgical complications after primary resection ( P = 0.025) of CRLM. Multivariate analysis before and after PSM revealed that the Memorial Sloan Kettering Cancer Center (MSKCC) score and CEA values are strong predictors for OS in patients with CRLM. Conclusions: NC was not associated with increased OS in patients suffering from CRLM. Additionally, potentially harmful chemotherapy prior to surgery increases the risk of postoperative complications in these patients.