Scholarlink

Background <p>FOLFOXIRI is associated with better response and higher resection rates than doublet regimens for colorectal liver metastases (CLM); however, irinotecan and oxaliplatin may cause liver injury, increasing the risk of hepatectomy. This study compared outcomes between patients receiving FOLFOXIRI versus FOLFOX/FOLFIRI before undergoing CLM resection.</p> Methods <p>This multicenter retrospective study included consecutive patients undergoing CLM resection during 2010–2021 after preoperative FOLFOXIRI or FOLFOX/FOLFIRI as first-line chemotherapy. Patients receiving multiple lines of therapy were excluded.</p> Results <p>Of 1711 patients included, 160 (9.4%) received FOLFOXIRI and 1551 (90.6%) received FOLFOX/FOLFIRI. Patients receiving FOLFOXIRI were younger (median age 55 vs. 59 years; <i>p</i>&#xa0;&lt;&#xa0;0.001), had a higher rate of synchronous CLM (93.7% vs. 78.7%; <i>p</i>&#xa0;&lt;&#xa0;0.001), and had a higher median tumor burden score (TBS; 5.6 vs. 4.1; <i>p</i>&#xa0;&lt;&#xa0;0.001). In both groups, a median of six cycles of preoperative chemotherapy were administered. Outcomes after FOLFOXIRI (vs. FOLFOX/FOLFIRI) were as follows: major hepatectomy, 44.4% of patients (vs. 35.3%; <i>p</i>&#xa0;=&#xa0;0.024), median estimated blood loss, 300 mL (vs. 200&#xa0;mL; <i>p</i>&#xa0;=&#xa0;0.006), rate of intraoperative blood transfusion, 8.1% (vs. 4.4%; <i>p</i>&#xa0;=&#xa0;0.034), 90-day major complication rate, 13.3% (vs. 10.0%; <i>p</i>&#xa0;=&#xa0;0.193), 90-day mortality rate, 1.2% (vs. 0.6%; <i>p</i>&#xa0;=&#xa0;0.324), and 5-year overall survival (OS) rate, 66.6% (vs. 56.4%; <i>p</i>&#xa0;=&#xa0;0.072). Medium–high TBS, synchronous extrahepatic disease, positive resection margin, and <i>RAS</i> mutation were independent risk factors for poor OS. Patients with medium–high TBS had a significantly better 5-year OS rate after FOLFOXIRI than after FOLFOX/FOLFIRI (67.6% vs. 50.1%; <i>p</i>&#xa0;=&#xa0;0.004).</p> Conclusion <p>In patients with CLM with higher disease burden, FOLFOXIRI may be preferable to FOLFOX/FOLFIRI for preoperative chemotherapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Short- and Long-Term Outcomes After Hepatectomy in Patients Receiving Triplet Versus Doublet Preoperative Chemotherapy for Colorectal Liver Metastases

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月1日

查看全文
  • Agostino M. De Rose,
  • Elena Panettieri,
  • Mateo Lendoire,
  • Yosuke Nakao,
  • Eleanor A. Fallon,
  • Caterina Mele,
  • Marc-Antoine Allard,
  • Timothy E. Newhook,
  • Francesco Ardito,
  • René Adam,
  • Jean-Nicolas Vauthey,
  • Felice Giuliante

摘要

Background

FOLFOXIRI is associated with better response and higher resection rates than doublet regimens for colorectal liver metastases (CLM); however, irinotecan and oxaliplatin may cause liver injury, increasing the risk of hepatectomy. This study compared outcomes between patients receiving FOLFOXIRI versus FOLFOX/FOLFIRI before undergoing CLM resection.

Methods

This multicenter retrospective study included consecutive patients undergoing CLM resection during 2010–2021 after preoperative FOLFOXIRI or FOLFOX/FOLFIRI as first-line chemotherapy. Patients receiving multiple lines of therapy were excluded.

Results

Of 1711 patients included, 160 (9.4%) received FOLFOXIRI and 1551 (90.6%) received FOLFOX/FOLFIRI. Patients receiving FOLFOXIRI were younger (median age 55 vs. 59 years; p < 0.001), had a higher rate of synchronous CLM (93.7% vs. 78.7%; p < 0.001), and had a higher median tumor burden score (TBS; 5.6 vs. 4.1; p < 0.001). In both groups, a median of six cycles of preoperative chemotherapy were administered. Outcomes after FOLFOXIRI (vs. FOLFOX/FOLFIRI) were as follows: major hepatectomy, 44.4% of patients (vs. 35.3%; p = 0.024), median estimated blood loss, 300 mL (vs. 200 mL; p = 0.006), rate of intraoperative blood transfusion, 8.1% (vs. 4.4%; p = 0.034), 90-day major complication rate, 13.3% (vs. 10.0%; p = 0.193), 90-day mortality rate, 1.2% (vs. 0.6%; p = 0.324), and 5-year overall survival (OS) rate, 66.6% (vs. 56.4%; p = 0.072). Medium–high TBS, synchronous extrahepatic disease, positive resection margin, and RAS mutation were independent risk factors for poor OS. Patients with medium–high TBS had a significantly better 5-year OS rate after FOLFOXIRI than after FOLFOX/FOLFIRI (67.6% vs. 50.1%; p = 0.004).

Conclusion

In patients with CLM with higher disease burden, FOLFOXIRI may be preferable to FOLFOX/FOLFIRI for preoperative chemotherapy.