Treatment with 5-Fluorouracil/Folinic Acid, Oxaliplatin, and Irinotecan Enables Surgical Resection of Metastases in Patients With Initially Unresectable Metastatic Colorectal Cancer |
| |
Authors: | Gianluca Masi MD Samanta Cupini MD Lorenzo Marcucci MD Elisa Cerri MD Fotios Loupakis MD Giacomo Allegrini MD Isa Maura Brunetti MD Elisabetta Pfanner MD Maurizio Viti MD Orlando Goletti MD Franco Filipponi MD Alfredo Falcone MD |
| |
Affiliation: | (1) Department of Oncology, Division of Medical Oncology, Presidio Ospedaliero, Viale Alfieri 36, Livorno, 57124, Italy;(2) Department of Oncology, Division of Medical Oncology, Ospedale Santa Chiara, Via Roma 67, Pisa, 56126, Italy;(3) Department of Oncology, Division of Surgery, Presidio Ospedaliero, Viale Alfieri 36, Livorno, 57124, Italy;(4) Department of Oncology, Division of Surgery, Ospedale Lotti, Via Roma 180, Pontedera, 56025, Italy;(5) Division of Liver Transplantation, University of Pisa, Via Paradisa 2, Pisa, 56124, Italy;(6) Cattedra di Oncologia Medica, University of Pisa, Via Roma 55, Pisa, 56126, Italy |
| |
Abstract: | Background The prognosis of unresectable metastatic colorectal cancer might be improved if a radical surgical resection of metastases could be performed after a response to chemotherapy. Methods We treated 74 patients with unresectable metastatic colorectal cancer (not selected for a neoadjuvant approach) with irinotecan, oxaliplatin, and 5-fluorouracil/leucovorin (FOLFOXIRI and simplified FOLFOXIRI). Because of the high activity of these regimens (response rate, 72%), a secondary curative operation could be performed in 19 patients (26%). Results Four patients underwent an extended hepatectomy, nine patients underwent a right hepatectomy, three patients underwent a left hepatectomy, and three patients had a segmental resection. In five patients, surgical removal of extrahepatic disease was also performed. In seven patients, surgical resection was combined with intraoperative radiofrequency ablation. The median overall survival of the 19 patients who underwent operation is 36.8 months, and the 4-year survival rate is 37%. The median overall survival of the 34 patients who were responsive to chemotherapy, but who did not undergo operation, is 22.2 months (P = .0114). Conclusions The FOLFOXIRI regimens we studied have significant antitumor activity and allow a radical surgical resection of metastases in patients with initially unresectable metastatic colorectal cancer not selected for a neoadjuvant approach and also those with extrahepatic disease. The median survival of patients with resected disease is promising. |
| |
Keywords: | 5-Fluorouracil Colorectal cancer Irinotecan Liver metastases Oxaliplatin |
本文献已被 PubMed SpringerLink 等数据库收录! |
|