ctDNA level after adjuvant chemotherapy. A large study that included two prospective databases with a total of 792 patients demonstrated that 5-FU–based chemotherapy improved survival (P = .007), even after stratification by clinical risk score (CRS) (P = .001). BACKGROUND: The 10-year overall survival with adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after resection of colorectal liver metastases (CRLMs) was 61% in clinical trials from Memorial Sloan Kettering Cancer Center. Thus, the long-term prognosis after resection or ablation remains unsatisfactory, and prevention of recurrence via adjuvant treatments is an important unmet medical need in patients with HCC. In this review, we evaluated the available evidence for the efficiency of adjuvant treatments to prevent HCC recurrence after curative liver resection. However, this animal model suggests the … Goéré D, Benhaim L, Bonnet S, Malka D, Faron M, Elias D, et al. However, the 5-year recurrence rates of HCC after surgery have been reported to range from 50% to 70%. Information collection and follow-up Jan 16, 2012 - 11:42 am. Evidence (adjuvant chemotherapy): A trial of hepatic arterial floxuridine and dexamethasone plus systemic 5-FU/LV compared with systemic 5-FU/LV alone showed improved 2-year PFS ... Intra-arterial chemotherapy after liver resection. My husband will be 4 weeks out from liver resection surgery tomorrow. 4 rounds every 3 weeks of Xeloda, oxi, and avastin. combining chemotherapy with resection of colorectal cancer liver metastases is of major interest. In humans, the route and schedule of adjuvant chemotherapy delivery after resection of hepatic metastases remains unclear. The objectives of this study were to determine the risk factors for IHCC recurrence after curative (R0) liver resection and to identify the feasibility about postoperative adjuvant radiation therapy (RT). This is in accordance with the 20% - 45 % five-year survival obtained with surgical resection of hepatic metastases. The role of adjuvant treatment post-liver resection should not be viewed in isolation but rather in the context of prior treatment, surgical preference, and individual patient characteristics. adjuvant chemotherapy with no chemotherapy after complete resection of CRLM demonstrated a trend to-wards increased disease-free survival (DFS) for patients receiving chemotherapy (27.9 vs. 18.8 months; p=0.095) [12]. Ongoing trial• HEPATICA study – two-arm, multicenter, randomized, comparative efficacy and … Japanese investigators recently faced the same problem of low accrual as in the FFCD and ENG trials in a phase III trial comparing surgery alone with adjuvant chemotherapy with oral leucovorin and tegafur/uracil after potentially curative liver resection. The trial was not powered for overall survival as an endpoint. Although colorectal oligometastases to the liver can potentially be cured with aggressive local ablation, the efficacy of adjuvant chemotherapy (ACT) for such metastasis remains unclear. Marginal statistical evidence of efficacy of adjuvant and/or perioperative chemotherapy after resection of colorectal metastases exists, but formal recommendations are still lacking. However, recurrence frequently occurs within the remaining liver as well as at extra-hepatic sites. His oncologist is going to start chemo on Thursday. However, ~ 60% of patients develop recurrent liver metastases after initial liver resection [5, 6]. Hope your dad goes on okay. Kiichi Sugimoto 1, Kazuhiro Sakamoto 1, Yuki Ii 2, Kota Amemiya 2, Hiroyuki Sugo 2, Tomoaki Ito 3, Adjuvant therapy is often used after primary treatments, such as surgery, to lessen the chance of your cancer coming back. In the present study, 163 CRCHM patients with liver resection after pre-operative chemotherapy were retrospectively analyzed. Expansion of the indication for liver resection and new regimens for systemic chemotherapy have improved postoperative outcomes for synchronous colorectal liver metastases (CRLM). This review discusses the possible However, 54 (29.8%) patients who had no adjuvant chemotherapy after resection of liver metastases, had received adjuvant chemotherapy after resection of the primary tumor. So far, the results of randomised trials of adjuvant chemotherapy given after liver resection either intravenously or through the hepatic artery have provided some indication that prognosis has improved, but the benefit of adjuvant chemotherapy has not yet been formally proven. Hepatic resection represents the first-line treatment for patients with resectable hepatocellular carcinoma (HCC). A comparative study between hepatic arterial infusion of oxaliplatin and modern systemic chemotherapy. However, such cases can still have a high recurrence rate, even after curative resection. patients were included in the liver resection group with no postoperative chemotherapy, and 57 patients were included in the postoperative adjuvant chemo-therapy group. Therefore, there is a need for postoperative adjuvant chemotherapy (POAC) after liver resection in … 2. Rationale: Hepatectomy and adjuvant chemotherapy after resection of colorectal liver metastases (CRLM) may improve survival, however, patients which may benefit cannot currently be identified. macroscopic disease (R0 resection). Selection. Anxious1. In addition, in one of these trials, adjuvant chemo-therapy was an independent favorable factor for DFS [13]. However, these results cannot be used to conclude that there is a lack of benefit for adjuvant chemotherapy after resection of CRC liver metastases. The role of adjuvant systemic chemotherapy in an attempt to reduce the incidence of recurrence has been investigated in several studies. Methods: Patients with resected CRLM treated at MSKCC with and without adjuvant HAI who had available KRAS status (wild-type, WT; mutated, MUT) were reviewed from a prospectively maintained institutional database. Adjuvant chemotherapy after resection of colorectal liver metastases in patients at high risk of hepatic recurrence. Correction to: Significance of postoperative adjuvant chemotherapy with an oxaliplatin-based regimen after simultaneous curative resection for colorectal cancer and synchronous colorectal liver metastasis: a propensity score matching analysis. Abstract. Adjuvant chemotherapy after resection of liver metastases from colorectal cancer 1. Ann Surg. Three-month adjuvant capecitabine plus oxaliplatin in combination (CAPOX) appeared to reduce recurrence, with mild toxicity in postcurative resection of colorectal cancer liver metastases (CLM). Background Two years after undergoing resection of liver metastases from colorectal cancer, about 65 percent of patients are alive and 25 percent are free of detectable disease. Adjuvant systemic chemotherapy administered after surgical resection of colorectal cancer metastases may reduce the risk of recurrence and improve survival, but its benefit has never been demonstrated. In general, postoperative adjuvant chemotherapy was started 1 month after surgery, when the curability of the liver resection was confirmed according to our standards. I believe that it is critical to have adjuvant chemo after liver resection. Adjuvant chemotherapy is usually FOLFOX, but HAI combined with systemic chemotherapy is also an option. Having two lots of previous adjuvant chemo which I believe have made no difference whatsoever to this now being in the third location within my body bowel 1st peritoneal 2nd now liver. The results showed a benefit in both RFS and OS in the adjuvant chemotherapy arm compared to the observation arm. After resection of colorectal liver metastases (CRLM), recurrent disease in the liver is a major cause of death but may be reduced with the addition of adjuvant hepatic arterial infusion (HAI) chemotherapy to systemic chemotherapy (SYS). The adjuvant chemotherapy The present study explored the effects of ACT on patients with colorectal liver oligometastases (CLO) after curative resections and aimed to identify patients who could benefit from ACT. The eligible population was grouped into two categories (chemotherapy or surveillance arm) according to the treatment with or without adjuvant chemotherapy following the liver resection. Several retrospective series have also shown benefit for adjuvant systemic treatment after liver resection. Blood sample collection and DNA extraction Blood samples were collected at diagnosis before treatment (baseline), before liver resection (pre-operation), after liver resection (post-operation), after completion of post-operative adjuvant chemotherapy (post-ACT) and in the event of disease progression (PD). Liver resection is the most effective curative treatment for patients with CRC liver metastasis, with a 5‐year survival rate of 40%–50% [3, 4]. The total chemotherapy administered, including that administered prior to and after liver resection, should not exceed 9 months. A total of 125 (42%) patients had a MSKCC-CRS > 2. Conclusion In a group of patients who underwent curative resection of hepatocellular carcinoma, postoperative adjuvant chemotherapy using the present regimen was associated with more frequent extrahepatic recurrences and a worse outcome. Colorectal liver metastases are common and found in almost 50% of patients with colorectal cancer. Patients treated with adjuvant chemotherapy had a 1.3 to 2.0 times higher chance … underwent adjuvant chemotherapy after the liver resection, the regimen was the same as the preoperative chemotherapy. 2013; 257:114–120. 12 With the benefit of adjuvant chemotherapy clearly established in resected stage III colon cancer, some consider that surgery alone is unethical after resection of stage IV disease and that adjuvant chemotherapy … Adjuvant oxaliplatin- or irinotecan-containing chemotherapy improves overall survival following resection of metachronous colorectal liver metastases 19 2010 Int J Colorectal Dis 20. Good morning, friends. Because of this high recurrence rate, adjuvant chemotherapy (ACT) has been investigated for patients with CRC metastasis to the liver. Although several studies have indicated the potential efficacy of ACT in prolonging survival, its benefits had not been definitively shown until now [ 7, 8, 9 ]. In almost one third of the cases, the liver was shown at autopsy to be the only site of cancer spread. Correlations between KRAS status, adjuvant HAI, clinical factors, and outcomes were analyzed. The role of adjuvant chemotherapy after potentially curative resection of liver metastases is uncertain. Six recent studies have examined the role of adjuvant chemotherapy after liver resection for metastatic colorectal cancer. Recurrence in patients who underwent the 3-month adjuvant CAPOX after resection of CLM was most commonly at extrahepatic sites. Even if your surgery was successful at removing all visible cancer, microscopic bits of cancer sometimes remain and are undetectable with current methods. Patients receiving curative resection (R0) were randomized to postoperative FOLFOX4 group and no FOLFOX4 group. Considering the impact of aggressive disease on post-surgery decisions, we further excluded 10 patients who had rapidly progressing disease within 1 month in the sensitivity analysis. In general, postoperative adjuvant chemotherapy was started 1 month after surgery, when the curability of the liver resection was confirmed according to our standards. Decisions to use ACT were based on patients’ tolerances and preferences, and was recommended to begin 4–6 weeks after liver resection. Among patients who underwent NAC, their ACT regimens were consistent with NAC. Recurrence risk in patients after liver resection was evaluated by the MSKCC-CRS [ 14 ]. Context Little information is available regarding the role of surgical resection for metastatic pancreatic carcinoma, especially that with multiple liver metastases.Objective The aim of the study was to evaluate the results of adjuvant surgery for pancreatic carcinoma patients with multiple liver metastases that responded well to combination chemotherapy. The majority of patients with intrahepatic cholangiocarcinoma (IHCC) who undergo complete tumor resection subsequently develop tumor recurrence. Appropriate imaging is essential to recognise the extent of liver metastases. [Google Scholar] The role of adjuvant TACE among patients after resection of HCC remains debated, with some investigators suggesting that adjuvant TACE may only benefit specific subsets of patients. I hope that you will seek a second opinion. Adjuvant HAI chemotherapy improves overall survival after liver resection. The aim of this study is to analyze the therapeutic effect of postoperative adjuvant chemotherapy with FOLFOX4 after hepatocarcinoma resection based on folate receptor-positive circulating tumor cells. The present study evaluated the adjuvant systemic chemotherapy after the first resection of liver and lung colorectal cancer metastases. (See "Hepatic resection for colorectal cancer liver metastasis", section on 'Outcomes' and "Systemic chemotherapy for metastatic colorectal cancer: General principles", section on 'Chemotherapy versus supportive care' .) Long-term, a proportion of patients undergoing hepatic metastasectomy may have long-term relapse-free survival and may be cured. Previous studies have not shown a clear benefit of adjuvant chemotherapy after metastasectomy of liver metastases. The first protocol of postoperative adjuvant chemotherapy lasted from October 1986 to December 1988. Introduction. Postoperative circulating tumor DNA (ctDNA) analysis can detect minimal residual disease (MRD) and predict the prognosis and efficacy of adjuvant chemotherapy. Hi @ Anxious1, I am due to have a liver resection next Friday 2nd, and no adjuvant chemo afterwards. Adjuvant therapy in HCC represents a considerable challenge, in particular because of the underlying liver disease present in almost all patients. In 25 (8.3%) patients the information on adjuvant chemotherapy was missing.

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