Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases
Background The optimal duration, safety, and benefit of preoperative chemotherapy in patients with colorectal liver metastases (CLM) are unclear. We evaluated the association between the duration of preoperative chemotherapy with 5-fluorouracil (5-FU), leucovorin, oxaliplatin (FOLFOX) ± bevacizumab,...
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| مؤلفون آخرون: | , , , , , , , , , , , |
| التنسيق: | article |
| منشور في: |
2010
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| الوصول للمادة أونلاين: | http://hdl.handle.net/10725/2618 http://dx.doi.org/10.1245/s10434-010-1166-1 http://link.springer.com/article/10.1245/s10434-010-1166-1 |
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| _version_ | 1864513458731483136 |
|---|---|
| author | Kishi, Yoji |
| author2 | Zorzi, Daria Contreras, Carlo Maru, Dipen Kopetz, Scott Ribero, Dario Motta, Manuela Ravarino, Nicoletta Risio, Mauro Curley, Steven Abdalla, Eddie Capussotti, Lorenzo Vauthey, Jean-Nicolas |
| author2_role | author author author author author author author author author author author author |
| author_facet | Kishi, Yoji Zorzi, Daria Contreras, Carlo Maru, Dipen Kopetz, Scott Ribero, Dario Motta, Manuela Ravarino, Nicoletta Risio, Mauro Curley, Steven Abdalla, Eddie Capussotti, Lorenzo Vauthey, Jean-Nicolas |
| author_role | author |
| dc.creator.none.fl_str_mv | Kishi, Yoji Zorzi, Daria Contreras, Carlo Maru, Dipen Kopetz, Scott Ribero, Dario Motta, Manuela Ravarino, Nicoletta Risio, Mauro Curley, Steven Abdalla, Eddie Capussotti, Lorenzo Vauthey, Jean-Nicolas |
| dc.date.none.fl_str_mv | 2010 2015-11-19T08:45:04Z 2015-11-19T08:45:04Z 2015-11-19 |
| dc.identifier.none.fl_str_mv | 1068-9265 http://hdl.handle.net/10725/2618 http://dx.doi.org/10.1245/s10434-010-1166-1 Kishi, Y., Zorzi, D., Contreras, C. M., Maru, D. M., Kopetz, S., Ribero, D., ... & Vauthey, J. N. (2010). Extended preoperative chemotherapy does not improve pathologic response and increases postoperative liver insufficiency after hepatic resection for colorectal liver metastases. Annals of surgical oncology, 17(11), 2870-2876. http://link.springer.com/article/10.1245/s10434-010-1166-1 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Annals of Surgical Oncology |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Background The optimal duration, safety, and benefit of preoperative chemotherapy in patients with colorectal liver metastases (CLM) are unclear. We evaluated the association between the duration of preoperative chemotherapy with 5-fluorouracil (5-FU), leucovorin, oxaliplatin (FOLFOX) ± bevacizumab, pathologic response, and hepatotoxicity after hepatic resection for CLM. Methods A total of 219 patients underwent hepatic resection following FOLFOX with or without bevacizumab and were divided into 2 groups according to the chemotherapy duration: 1–8 cycles (short duration [SD]; N = 157) and ≥9 cycles (long duration [LD]; N = 62). The frequency of complete or major pathologic response, sinusoidal injury, and major postoperative morbidity were compared. Results Treatment consisting of ≥9 cycles was not associated with an increase in complete or major pathologic response (SD vs. LD, 57% vs. 55%; P = .74). The incidence of sinusoidal injury was higher in the LD group (26% vs. 42%; P = .017). The incidence of liver insufficiency was higher in the LD group (4% vs. 11%; P = .035). Sinusoidal injury did not predict postoperative liver insufficiency; multivariate analysis revealed ≥9 cycles was the only independent predictor of postoperative liver insufficiency (P = .031; odds ratio = 3.90). Chemotherapy including bevacizumab was associated with a significantly higher frequency of complete or major response in both SD and LD groups. Conclusions Extended preoperative chemotherapy increases the risk of hepatotoxicity in CLM without improving the pathologic response. The type of chemotherapy (FOLFOX with bevacizumab) has more impact on pathologic response than the duration of chemotherapy.Background The optimal duration, safety, and benefit of preoperative chemotherapy in patients with colorectal liver metastases (CLM) are unclear. We evaluated the association between the duration of preoperative chemotherapy with 5-fluorouracil (5-FU), leucovorin, oxaliplatin (FOLFOX) ± bevacizumab, pathologic response, and hepatotoxicity after hepatic resection for CLM. Methods A total of 219 patients underwent hepatic resection following FOLFOX with or without bevacizumab and were divided into 2 groups according to the chemotherapy duration: 1–8 cycles (short duration [SD]; N = 157) and ≥9 cycles (long duration [LD]; N = 62). The frequency of complete or major pathologic response, sinusoidal injury, and major postoperative morbidity were compared. Results Treatment consisting of ≥9 cycles was not associated with an increase in complete or major pathologic response (SD vs. LD, 57% vs. 55%; P = .74). The incidence of sinusoidal injury was higher in the LD group (26% vs. 42%; P = .017). The incidence of liver insufficiency was higher in the LD group (4% vs. 11%; P = .035). Sinusoidal injury did not predict postoperative liver insufficiency; multivariate analysis revealed ≥9 cycles was the only independent predictor of postoperative liver insufficiency (P = .031; odds ratio = 3.90). Chemotherapy including bevacizumab was associated with a significantly higher frequency of complete or major response in both SD and LD groups. Conclusions Extended preoperative chemotherapy increases the risk of hepatotoxicity in CLM without improving the pathologic response. The type of chemotherapy (FOLFOX with bevacizumab) has more impact on pathologic response than the duration of chemotherapy. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_9c074e704513048a9b351d9a2184f33a |
| identifier_str_mv | 1068-9265 Kishi, Y., Zorzi, D., Contreras, C. M., Maru, D. M., Kopetz, S., Ribero, D., ... & Vauthey, J. N. (2010). Extended preoperative chemotherapy does not improve pathologic response and increases postoperative liver insufficiency after hepatic resection for colorectal liver metastases. Annals of surgical oncology, 17(11), 2870-2876. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2618 |
| publishDate | 2010 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver MetastasesKishi, YojiZorzi, DariaContreras, CarloMaru, DipenKopetz, ScottRibero, DarioMotta, ManuelaRavarino, NicolettaRisio, MauroCurley, StevenAbdalla, EddieCapussotti, LorenzoVauthey, Jean-NicolasBackground The optimal duration, safety, and benefit of preoperative chemotherapy in patients with colorectal liver metastases (CLM) are unclear. We evaluated the association between the duration of preoperative chemotherapy with 5-fluorouracil (5-FU), leucovorin, oxaliplatin (FOLFOX) ± bevacizumab, pathologic response, and hepatotoxicity after hepatic resection for CLM. Methods A total of 219 patients underwent hepatic resection following FOLFOX with or without bevacizumab and were divided into 2 groups according to the chemotherapy duration: 1–8 cycles (short duration [SD]; N = 157) and ≥9 cycles (long duration [LD]; N = 62). The frequency of complete or major pathologic response, sinusoidal injury, and major postoperative morbidity were compared. Results Treatment consisting of ≥9 cycles was not associated with an increase in complete or major pathologic response (SD vs. LD, 57% vs. 55%; P = .74). The incidence of sinusoidal injury was higher in the LD group (26% vs. 42%; P = .017). The incidence of liver insufficiency was higher in the LD group (4% vs. 11%; P = .035). Sinusoidal injury did not predict postoperative liver insufficiency; multivariate analysis revealed ≥9 cycles was the only independent predictor of postoperative liver insufficiency (P = .031; odds ratio = 3.90). Chemotherapy including bevacizumab was associated with a significantly higher frequency of complete or major response in both SD and LD groups. Conclusions Extended preoperative chemotherapy increases the risk of hepatotoxicity in CLM without improving the pathologic response. The type of chemotherapy (FOLFOX with bevacizumab) has more impact on pathologic response than the duration of chemotherapy.Background The optimal duration, safety, and benefit of preoperative chemotherapy in patients with colorectal liver metastases (CLM) are unclear. We evaluated the association between the duration of preoperative chemotherapy with 5-fluorouracil (5-FU), leucovorin, oxaliplatin (FOLFOX) ± bevacizumab, pathologic response, and hepatotoxicity after hepatic resection for CLM. Methods A total of 219 patients underwent hepatic resection following FOLFOX with or without bevacizumab and were divided into 2 groups according to the chemotherapy duration: 1–8 cycles (short duration [SD]; N = 157) and ≥9 cycles (long duration [LD]; N = 62). The frequency of complete or major pathologic response, sinusoidal injury, and major postoperative morbidity were compared. Results Treatment consisting of ≥9 cycles was not associated with an increase in complete or major pathologic response (SD vs. LD, 57% vs. 55%; P = .74). The incidence of sinusoidal injury was higher in the LD group (26% vs. 42%; P = .017). The incidence of liver insufficiency was higher in the LD group (4% vs. 11%; P = .035). Sinusoidal injury did not predict postoperative liver insufficiency; multivariate analysis revealed ≥9 cycles was the only independent predictor of postoperative liver insufficiency (P = .031; odds ratio = 3.90). Chemotherapy including bevacizumab was associated with a significantly higher frequency of complete or major response in both SD and LD groups. Conclusions Extended preoperative chemotherapy increases the risk of hepatotoxicity in CLM without improving the pathologic response. The type of chemotherapy (FOLFOX with bevacizumab) has more impact on pathologic response than the duration of chemotherapy.PublishedN/A2015-11-19T08:45:04Z2015-11-19T08:45:04Z20102015-11-19Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1068-9265http://hdl.handle.net/10725/2618http://dx.doi.org/10.1245/s10434-010-1166-1Kishi, Y., Zorzi, D., Contreras, C. M., Maru, D. M., Kopetz, S., Ribero, D., ... & Vauthey, J. N. (2010). Extended preoperative chemotherapy does not improve pathologic response and increases postoperative liver insufficiency after hepatic resection for colorectal liver metastases. Annals of surgical oncology, 17(11), 2870-2876.http://link.springer.com/article/10.1245/s10434-010-1166-1enAnnals of Surgical Oncologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26182019-02-26T08:27:25Z |
| spellingShingle | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases Kishi, Yoji |
| status_str | publishedVersion |
| title | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases |
| title_full | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases |
| title_fullStr | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases |
| title_full_unstemmed | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases |
| title_short | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases |
| title_sort | Extended Preoperative Chemotherapy Does Not Improve Pathologic Response and Increases Postoperative Liver Insufficiency After Hepatic Resection for Colorectal Liver Metastases |
| url | http://hdl.handle.net/10725/2618 http://dx.doi.org/10.1245/s10434-010-1166-1 http://link.springer.com/article/10.1245/s10434-010-1166-1 |