e14523 Background: Whether patients with resectable colorectal liver metastases (CRLM) receive a survival benefit from neoadjuvant chemotherapy prior to hepatectomy remains controversial. Methods: We retrospectively analyzed 466 consecutive patients with resectable CRLM between 2000 and 2010. Patient and tumor characteristics, surgical procedure and survival data were recorded. Results: The patients were divided into two groups: one group with neoadjuvant chemotherapy (group NC, n=121) and one group without (group WN, n=345). There was no significant difference in the median survival (60.0 m vs. 53.9 m) or 5-year survival (52% vs. 48%) between the two groups. No significant differences were identified between the two groups in terms of 30-day mortality (1.7% vs. 1.2%) or morbidity (33.9% vs. 25.8%). A primary tumor at stage T4, ≥ 4 liver metastases, the largest liver metastasis ≥ 5 cm in diameter, and a serum CEA level ≥ 5 ng/ml were independent prognostic factors for the surgical patients. By assigning one point to each of above factors, all of the patients were divided into a low-risk group (0-2) and a high-risk (3-4). The patients in the low-risk group received no survival benefit from neoadjuvant chemotherapy, whereas those in the high-risk group received a survival benefit (median survival, 38.9 m vs. 28.4 m; 5-year survival, 39% vs. 33%, P=0.028). Conclusions: Preoperative neoadjuvant chemotherapy did not significantly increase mortality or complications. Not all resectable patients (only those with more than 2 independent risk factors) receive a survival benefit from neoadjuvant chemotherapy.
Effect of neoadjuvant chemotherapy in patients with resectable colorectal liver metastases.
