Introduction

In resected colonic liver metastasis (CLM), randomized studies of oxaliplatin-based chemotherapy have demonstrated improvements in disease-free survival (DFS), but not overall survival (OS). Additionally, oxaliplatin regimens have not been compared to non-oxaliplatin chemotherapy. Despite limited evidence, perioperative chemotherapy is often used in the management of CLM. The primary aim of this study was to assess the impact of oxaliplatin chemotherapy regimens on OS in patients who have undergone resection of CLM in a real-world setting.

Patients and Methods

Patients who underwent resection of CLM in the provinces of Alberta and British Columbia, Canada, were identified from 1996 to 2016. Perioperative (pre- and/or post-) systemic therapy was categorized as oxaliplatin or non-oxaliplatin-based chemotherapy or no chemotherapy. The primary and secondary outcomes were OS and DFS, respectively.

Results

We identified 511 patients who underwent R0 resection of CLM. A significant difference in median OS was identified among the oxaliplatin, non-oxaliplatin, and no-chemotherapy groups of 100, 60, and 59 months, respectively (P = .009). In multivariate analysis, patients who received oxaliplatin regimens had a lower risk of death (hazard ratio, 0.68; 95% confidence interval, 0.51-0.92; P = .012), whereas the non-oxaliplatin chemotherapy group did not (hazard ratio, 0.88; 95% confidence interval, 0.65-1.20; P = .422) compared with no chemotherapy.

Conclusions

In this multicenter, retrospective, population-based study, perioperative oxaliplatin-based chemotherapy was associated with improved OS in conjunction with R0 resection of CLM. Further studies should evaluate the optimal duration and sequencing of perioperative chemotherapy in relation to curative-intent surgical resection of CLM.

中文翻译：

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以奥沙利铂为基础的化疗治疗 R0 切除结肠肝转移的真实结果

介绍

在切除的结肠肝转移 (CLM) 中，基于奥沙利铂的化疗的随机研究表明无病生存期 (DFS) 有所改善，但总生存期 (OS) 没有改善。此外，尚未将奥沙利铂方案与非奥沙利铂化疗方案进行比较。尽管证据有限，但围手术期化疗常用于 CLM 的管理。本研究的主要目的是评估奥沙利铂化疗方案对在现实世界中接受 CLM 切除术的患者 OS 的影响。

患者和方法

1996 年至 2016 年在加拿大阿尔伯塔省和不列颠哥伦比亚省接受 CLM 切除术的患者被确定。围手术期（术前和/或术后）全身治疗分为奥沙利铂或非奥沙利铂化疗或无化疗. 主要和次要结局分别是 OS 和 DFS。

结果

我们确定了 511 名接受 CLM R0 切除的患者。奥沙利铂组、非奥沙利铂组和非化疗组分别在 100、60 和 59 个月时发现中位 OS 存在显着差异（P  = .009）。在多变量分析中，接受奥沙利铂方案的患者死亡风险较低（风险比，0.68；95% 置信区间，0.51-0.92；P  = 0.012），而非奥沙利铂化疗组则没有（风险比，0.88 ; 95% 置信区间, 0.65-1.20; P  = .422) 与未化疗相比。

结论

在这项多中心、回顾性、基于人群的研究中，以奥沙利铂为基础的围手术期化疗与 CLM 的 R0 切除联合改善 OS 相关。进一步的研究应评估与 CLM 的根治性手术切除相关的围手术期化疗的最佳持续时间和顺序。