Clinical Analysis Of Neoadjuvant Chemotherapy In Colon Cancer Patients With Resectable Liver Metastasis

Objective:To compare the efficacy of neoadjuvant chemotherapy with surgery alone in colon cancer patients with resectable liver metastasis.We assessed whether the addition of neoadjuvant chemotherapy before surgery improves outcomes among these patients.And to assess the value of neoadjuvant chemotherapy in colon cancer patients with resectable liver metastasis.Methods:We retrospectively analyzed the selected 85 colon cancer patients with resectable liver metastasis who received surgery at Cancer Institute and Hospital,Chinese Academy of Medical Sciences from 2010.1 to 2015.12.Based on their exposure to neoadjuvant chemotherapy,those patients were divided into either neoadjuvant chemotherapy and surgery(n=37)or surgery alone(n=48).The two groups were comparable with no differences regarding the clinical parameters.The survival analysis was performed by the Kaplan-Meier method,and the Log-rank test was used to determine the statistical significance of differences.Factors that were associated with survival in the univariate analysis were entered into a multivariate analysis(COX)to test for significant effects.And P<0.05 is considered significant effects.Result:Patients in group with neoadjuvant chemotherapy had a media overall survival(OS)of 36 months,and media disease-free survival(DFS)of 19 months.The 3-and 1-year OS rates were 33%and80%,respectively.In comparison,patients in group without neoadjuvant chemotherapy had a similar OS and DFS(31 months and 16 months,P>0.05).The 3-and 1-year overall survival rates were 25%and 67%,respectively.There was no difference in OS and DFS between the two groups.However,in the univariate analysis,factors include the location of primary tumor,?4 liver metastases,the largest liver metastasis>5 cm in diameter,a high serum CEA level,and the edge of the surgery of R1 are relative factors for colon cancer patients with liver metastasis.In the multivariate analysis,factors of the largest liver metastasis>5 cm in diameter,a high serum CEA level,and the edge of the surgery wasRl were found to be associated with increased risk of death.Conclusion:Neoadjuvant chemotherapy did not increase mortality or complications when compared with surgery alone.But neoadjuvant chemotherapy also did not improve the overall survival and disease free survival in those patients.And factors like the largest liver metastasis>5 cm in diameter,a high serum CEA level,and the edge of the surgery was R1 were associated with increased risk of death.