Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma Journal Article
| Authors: | Leonard, G. D.; Brenner, B.; Kemeny, N. E. |
| Article Title: | Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma |
| Abstract: | Colorectal carcinoma is one of the most common cancers in the world, and more than 50% of these patients develop liver metastases. Despite recent advances, systemic chemotherapy for metastatic disease without the use of surgery is considered palliative, as there are rarely long-term survivors. However, patients who are candidates for surgical resection of their liver metastases can have a prolonged survival or possibly a cure. Consensus guidelines on criteria for resection and prognostic scores help facilitate patient selection, yet only 25% of patients with liver metastases are considered to have resectable metastases. Neoadjuvant chemotherapy has been explored in an attempt to render more patients candidates for resection. First reports using neoadjuvant systemic chemotherapy in patients with unresectable disease found that 13% to 16% of patients could be rendered resectable. Efforts to increase response rates using hepatic arterial infusion or biologic agents may increase resection rates. This review summarizes the current data on neoadjuvant chemotherapy, the rationale for this approach, potential complications, and future prospects. © 2005 by American Society of Clinical Oncology. |
| Keywords: | survival; cancer chemotherapy; cancer survival; survival analysis; clinical trial; mortality; review; cisplatin; doxorubicin; fluorouracil; monotherapy; antineoplastic agents; liver neoplasms; capecitabine; adjuvant therapy; chemotherapy, adjuvant; outcome assessment; antineoplastic agent; metastasis; controlled clinical trial; randomized controlled trial; palliative therapy; combination chemotherapy; practice guideline; pathology; surgical approach; irinotecan; colorectal carcinoma; colorectal neoplasms; liver metastasis; randomized controlled trials; colorectal tumor; folinic acid; adjuvant chemotherapy; liver tumor; scoring system; liver resection; mitomycin; oxaliplatin; pirarubicin |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 23 |
| Issue: | 9 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2005-03-20 |
| Start Page: | 2038 |
| End Page: | 2048 |
| Language: | English |
| DOI: | 10.1200/jco.2005.00.349 |
| PROVIDER: | scopus |
| PUBMED: | 15774795 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 155" - "Export Date: 24 October 2012" - "CODEN: JCOND" - "Source: Scopus" |
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