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Extrahepatic recurrence rates in patients receiving adjuvant hepatic artery infusion and systemic chemotherapy after complete resection of colorectal liver metastases
Author(s) -
Srouji Rami M.,
Narayan Raja R.,
Boerner Thomas,
Buisman Florian E.,
Seier Kenneth,
Gonen Mithat,
Balachandran Vinod P.,
Drebin Jeffrey A.,
Jarnagin William R.,
Kingham T. Peter,
Wei Alice,
Kemeny Nancy E.,
D'Angelica Michael I.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26221
Subject(s) - medicine , hepatic arterial infusion , colorectal cancer , chemotherapy , gastroenterology , surgery , adjuvant chemotherapy , resection , incidence (geometry) , cancer , physics , breast cancer , optics
Background This study investigated the effect of the reduced dose of systemic chemotherapy (SYS) on recurrence patterns in patients receiving adjuvant hepatic artery infusion (HAI) chemotherapy after complete colorectal liver metastases (CRLM) resection. Methods Patients undergoing complete CRLM resection between 2000 and 2007 were selected from a prospectively maintained database and categorized as receiving SYS or HAI + SYS. Those with pre and/or intraoperative extrahepatic disease, documented death, or recurrence within 30 days of CRLM resection were excluded. Competing risk, Fine and Gray's tests were used to compare SYS versus HAI + SYS for time‐to‐organ recurrence. Results Of 361 study patients, 153 (42.4%) received SYS and 208 (57.6%) received HAI + SYS. The median follow‐up for survivors was 100 (range = 12–185) and 156 months (range = 18–217) for SYS and HAI + SYS, respectively. The 5‐year cumulative incidence (CI) of any liver recurrence was greater for those receiving SYS (SYS = 41.9% vs. HAI + SYS = 28.6%, p = .005). The 5‐year CI of developing any lung or extrahepatic recurrence for SYS patients was 36.2% and 47.9% compared with 44.5% ( p = .242) and 51.7% ( p = .551), respectively, in patients receiving HAI + SYS. Conclusion Despite the reduced dose of SYS, adjuvant HAI + SYS after CRLM resection is not associated with a significantly increased risk of extrahepatic recurrence.