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Perioperative second-line chemotherapy is beneficial for resectable liver metastases that occur during or early after adjuvant chemotherapy for colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

The prognosis of patients with liver metastases during or early after adjuvant chemotherapy for colorectal cancer (CRC) is significantly worse. This study aimed to explore the efficacy of perioperative second-line chemotherapy in prolonging survival in those patients.

Methods

Patients who underwent liver resection, with resectable liver metastases that occurred within 12 months after the last cycle of adjuvant chemotherapy for CRC, from January 2006 to December 2019, were included. The long-term outcome of overall survival (OS) and progression-free survival (PFS) between different groups was analyzed.

Results

A total of 200 patients were included, of whom 112 underwent direct hepatectomy and 88 received upfront second-line chemotherapy. OS and PFS were significantly better in patients receiving upfront second-line chemotherapy than direct surgery (PFS, P = 0.016; OS, P = 0.013). Further analysis showed that perioperative second-line chemotherapy could provide a greater survival benefit, which was also confirmed by propensity score matching (OS: P = 0.03; PFS: P = 0.04). Multivariate analysis determined that perioperative second-line chemotherapy was an independent factor influencing OS (OR [95% CI]: 0.468 [0.294–0.744], P = 0.001) and PFS (OR [95% CI]: 0.517 [0.353–0.758], P = 0.001).

Discussion

Perioperative second-line chemotherapy could improve the survival of patients who underwent hepatectomy, with resectable liver metastases that occurred during or early after adjuvant chemotherapy for CRC.

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Funding

This study was funded by grants (No. 81874143, No. 31971192) from the National Nature Science Foundation of China and the Beijing Natural Science Foundation (No. 7192035). The manuscript is being submitted as an original article. The research has never been presented on a previous communication to a society or meeting.

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Author notes

  1. Da Xu and Hai-Bin Zhu contributed equally to this work.

Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education/Beijing), Hepatopancreatobiliary Surgery Department I, Peking University Cancer Hospital & Institute, Haidian District, 52 Fucheng Road, Beijing, 100142, China

    Da Xu, Yan-Yan Wang, Ke-Min Jin, Xiao-Luan Yan, Juan Li, Kun Wang & Bao-Cai Xing

  2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing, 100142, China

    Hai-Bin Zhu

Authors
  1. Da Xu
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  3. Yan-Yan Wang
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Correspondence to Bao-Cai Xing.

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Xu, D., Zhu, HB., Wang, YY. et al. Perioperative second-line chemotherapy is beneficial for resectable liver metastases that occur during or early after adjuvant chemotherapy for colorectal cancer. Int J Colorectal Dis 37, 805–814 (2022). https://doi.org/10.1007/s00384-022-04111-z

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  • DOI: https://doi.org/10.1007/s00384-022-04111-z

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