Prolonged survival of initially unresectable hepatic colorectal cancer patients treated with hepatic arterial infusion of oxaliplatin followed by radical surgery of metastases

Détails

ID Serval
serval:BIB_8442D38B636B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prolonged survival of initially unresectable hepatic colorectal cancer patients treated with hepatic arterial infusion of oxaliplatin followed by radical surgery of metastases
Périodique
Ann Surg
Auteur(s)
Goere D., Deshaies I., de Baere T., Boige V., Malka D., Dumont F., Dromain C., Ducreux M., Elias D.
ISSN-L
1528-1140 (Electronic)0003-4932 (Linking)
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
251
Numéro
4
Pages
686-91
Langue
anglais
Notes
Goere, DianeDeshaies, Isabellede Baere, ThierryBoige, ValerieMalka, DavidDumont, FredericDromain, ClarisseDucreux, MichelElias, Dominiqueeng2010/03/13 06:00Ann Surg. 2010 Apr;251(4):686-91. doi: 10.1097/SLA.0b013e3181d35983.
Résumé
PURPOSE: The aim of this study was to analyze the impact of hepatic arterial infusion (HAI) of oxaliplatin with systemic 5-Fluorouracil and leucovorin on patients with isolated unresectable liver metastases. PATIENTS AND METHODS: A total of 87 patients treated in our hospital with HAI of oxaliplatin with systemic 5-Fluorouracil and leucovorin for isolated unresectable colorectal liver metastases from May 1999 to May 2007 were extracted from a prospective database and analyzed. The resectability rate, perioperative findings, postoperative outcomes, and long-term follow-up were evaluated. RESULTS: HAI was delivered after failure of previous systemic chemotherapy in 69 patients (79%). The main criterion for unresectability was massive liver involvement (86% of patients). Most patients had synchronous (85%), bilateral metastases (89%). The median number of HAI courses was 8 (0-25). About 31 patients experienced technical catheter-related problems, which were responsible for withdrawal of HAI in only 7 patients (8%). Finally, a total of 23 patients (26%) were operated on, and resection or radiofrequency ablation was performed in 21 patients (24%). No postoperative mortality was observed and the morbidity rate was 35%. Five-year overall survival was 56% in the surgery group versus none in the nonsurgery group (P < 0.0001). After a median follow-up of 63 months, intrahepatic recurrence occurred in 10 patients among the 23 operated patients. CONCLUSIONS: HAI of oxaliplatin with systemic 5-Fluorouracil and leucovorin offers a second chance to remove initially unresectable isolated colorectal liver metastases in 24% of patients, and appears to be more efficient when performed as first-line therapy. Long-term overall survival can be obtained with this approach.
Mots-clé
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/administration & dosage, Chemotherapy, Adjuvant, Colorectal Neoplasms/*pathology, Female, Fluorouracil/administration & dosage, *Hepatic Artery, Humans, *Infusions, Intra-Arterial/adverse effects, Leucovorin/administration & dosage, Liver Neoplasms/drug therapy/mortality/*secondary/*surgery, Male, Middle Aged, Organoplatinum Compounds/*administration & dosage, Survival Rate
Création de la notice
16/09/2016 11:14
Dernière modification de la notice
03/03/2018 18:54
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