Efficacy of postoperative oxaliplatin- or irinotecan-based chemotherapy after curative resection of synchronous liver metastases from colorectal cancer.

Background: Postoperative 5-fluorouracil (5-FU)-based chemotherapy improves survival after resection of synchronous liver metastases from colorectal cancer (CRLM). We retrospectively assessed the efficacy of postoperative chemotherapy with a modern regimen containing of oxaliplatin or irinotecan after curative resection of synchronous CRLM.

Patients And Methods: Seventy-two patients who received postoperative chemotherapy following curative resection of synchronous CRLM were analyzed. Patients were categorized into fluorouracil plus leucovorin (5-FU/LV, n=25), irinotecan-based regimen (FOLFIRI/IFL, n=21) and oxaliplatin-based regimen (FOLFOX, n=26) groups, according to the postoperative chemotherapy regimen. The clinicopathological parameters of patients were analyzed to evaluate clinical outcome.

Results: Median relapse-free survival (RFS) was 14.4 months in the 5-FU/LV group vs. 20.8 months in the FOLFIRI/IFL group (p=0.032) and 18.8 months in the FOLFOX regimen (p=0.123). Median overall survival (OS) was >60 months in the FOLFOX and FOLFIRI/IFL groups vs. 38.5 months in the 5-FU/LV group (p=0.002 and p=0.019, respectively). In multivariate analysis, administrations of FOLFIRI/IFL or FOLFOX regimens were independent predictive factors for favorable RFS. Administration of the FOLFIRI/IFL regimen was the only independent predictive factor for favorable OS.

Conclusion: Postoperative FOLFIRI/IFL and FOLFOX chemotherapy lead to more favorable RFS than 5-FU/LV following curative resection of synchronous CRLM.