Outcome in disappearing colorectal cancer liver metastases during oxaliplatin-based chemotherapy
- Authors:
- Tomojiro Ono
- Hideyuki Ishida
- Kensuke Kumamoto
- Norimichi Okada
- Keiichiro Ishibashi
View Affiliations
Affiliations: Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama 350-8550, Japan
- Published online on: August 3, 2012 https://doi.org/10.3892/ol.2012.842
-
Pages:
905-909
Metrics: Total
Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
This article is mentioned in:
Abstract
Some colorectal cancer liver metastases (CLMs) disappear on serial imaging during chemotherapy and the optimal treatment strategy for such lesions remains undetermined. The purpose of this study was to investigate the outcome in disappearing CLMs, as few studies have focused on this topic, with conflicting results. Among 125 patients with CLMs treated with modified FOLFOX6 with or without bevacizumab, those in whom all CLMs disappeared on computed tomography were identified. Recurrence of such disappearing lesions in situ was examined on a tumor-by‑tumor basis. Five (4%) patients with a total of 44 CLMs met the evaluation criteria. The median number of CLMs prior to chemotherapy was 8 (range, 2-16). The median maximal diameter of the CLMs was 1.8 cm (range, 1.0-2.4). The median time-to-disappearance of all eligible lesions was 6.5 months (range, 4.5-7.5). Histological examination of scar lesions on the liver surface revealed no viable cancer cells. Two lesions were surgically resected. During clinical follow-up of the remaining 42 lesions, in situ recurrence was observed in 8. The cumulative 1-, 2- and 3-year rates of relapse in situ were 9.1, 9.1 and 31.1%, respectively. Given the low risk of recurrence in situ, the results suggest that the sites of disappearing CLMs may be left unresected but should be carefully monitored during follow-up, with resection an option if the lesion should recur. However, to validate such a treatment strategy, further investigation with a larger series of patients is warranted.
View References
1.
|
B NordlingerH SorbyeB GlimeliusEORTC
Gastro-Intestinal Tract Cancer Group; Cancer Research UK;
Arbeitsgruppe Lebermetastasen und-tumoren in der Chirurgischen
Arbeitsgemeinschaft Onkologie (ALM-CAO); Australasian
Gastro-Intestinal Trials Group (AGITG); Fédération Francophone de
Cancérologie Digestive (FFCD)Perioperative chemotherapy with
FOLFOX4 and surgery versus surgery alone for resectable liver
metastases from colorectal cancer (EORTC Intergroup trial 40983): a
randomised controlled
trialLancet37110071016200810.1016/S0140-6736(08)60455-9
|
2.
|
R WongD CunninghamY BarbachanoA
multicentre study of capecitabine, oxaliplatin plus bevacizumab as
perioperative treatment of patients with poor-risk colorectal
liver-only metastases not selected for upfront resectionAnn
Oncol2220422048201110.1093/annonc/mdq71421285134
|
3.
|
C BokemeyerI BondarenkoA
MakhsonFluorouracil, leucovorin, and oxaliplatin with and without
cetuximab in the first-line treatment of metastatic colorectal
cancerJ Clin Oncol27663671200010.1200/JCO.2008.20.839719114683
|
4.
|
National Cancer InstituteCommon
terminology criteria for adverse events (CTCAE) v4.0http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm#ctc_40.
Accessed April 23, 2012.
|
5.
|
S BenoistA BrouquetC PennaComplete
response of colorectal liver metastases after chemotherapy: does it
mean cure?J Clin
Oncol2439393945200610.1200/JCO.2006.05.872716921046
|
6.
|
G FiorentiniA Del ConteM De SimoneComplete
response of colorectal liver metastases after intra-arterial
chemotherapyTumori94489492200818822683
|
7.
|
D EliasD GoereV BoigeN Kohneh-SharhiD
MalkaG TomasicC DromainM DucreuxOutcome of posthepatectomy-missing
colorectal liver metastases after complete response to
chemotherapy: impact of adjuvant intra-arterial hepatic
oxaliplatinAnn Surg
Oncol1431883194200710.1245/s10434-007-9482-9
|
8.
|
RC AuerRR WhiteNE KemenyPredictors of a
true complete response among disappearing liver metastases from
colorectal cancer after
chemotherapyCancer11615021509201010.1002/cncr.2491220120032
|
9.
|
MG van VledderMC de JongTM PawlikRD
SchulickLA DiazMA ChotiDisappearing colorectal liver metastases
after chemotherapy: should we be concerned?J Gastrointest
Surg1416911700201020839072
|
10.
|
K TanakaH TakakuraK TakedaK MatuoY NaganoI
EndoImportance of complete pathologic response to prehepatectomy
chemotherapy in treating colorectal cancer metastasesAnn
Surg250935942200910.1097/SLA.0b013e3181b0c6e419953712
|
11.
|
M KlingerS EpieldauerS HackerBevacizumab
protects against sinusoidal obstruction syndrome and does not
increase response rate in neoadjuvant XELOX/FOLFOX therapy of
colorectal cancer liver metastasesEur J Surg
Oncol35515520200910.1016/j.ejso.2008.12.013
|
12.
|
EA EisenhauerP TherasseJ BogaertsNew
response evaluation criteria in solid tumors: revised RECIST
guideline (version 1.1)Eur J
Cancer45228247200910.1016/j.ejca.2008.10.026
|
13.
|
S BhattacharjyaT BhattacharjyaS BaberJM
TibballsAF WatkinsonBR DavidsonProspective study of
contrast-enhanced computed tomography, computed tomography during
arterioportography, and magnetic resonance imaging for staging
colorectal liver metastases for liver resectionBr J
Surg9113611369200410.1002/bjs.4699
|
14.
|
S BipatMS van LeeuwenEF ComansColorectal
liver metastases: CT, MR imaging, and PET for diagnosis -
meta-analysisRadiology237123131200510.1148/radiol.237104206016100087
|
15.
|
C VallasE AndíaA SánchezHepatic metastases
from colorectal cancer: Preoperative detection and assessment of
respectability with helical
CTRadiology2185560200110.1148/radiology.218.1.r01dc115511152779
|
16.
|
D EliasL SiderisM PocardIncidence of
unsuspected and treatable metastatic disease associated with
operable colorectal liver metastases discovered only at laparotomy
(and not treated when performing percutaneous radiofrequency
ablation)Ann Surg Oncol12298302200510.1245/ASO.2005.03.020
|
17.
|
FG FernandezJ RitterJW GoodwinDC LinehanWG
HawkinsSM StrasbergEffect of steatohepatitis associated with
irinotecan or oxaliplatin pretreatment on resectability of hepatic
colorectal metastasesJ Am Coll
Surg200845853200510.1016/j.jamcollsurg.2005.01.024
|