Hepatic Resection After Prehepatectomy Chemotherapy for Metastatic Colorectal Cancer: A Propensity-Matched Analysis

Abstract

Background: Liver metastases from colorectal cancer (CRC) are best managed using multiple modalities, but the role of chemotherapy prior to resection of marginally resectable liver metastases remains unsettled.

Patients and methods: Consecutive patients treated for marginally resectable CRC liver metastases were matched using a propensity-score analysis based on the probability of a patient having up-front surgery or prehepatectomy chemotherapy followed by surgery.

Results: The study group consisted of 70 propensity-matched patients undergoing up-front surgery or prehepatectomy chemotherapy followed by surgery. Groups were similar in terms of baseline characteristics. Median estimated blood loss (605 ml vs. 957 ml, p=0.006), number of patients requiring transfusion (5 vs. 14, p=0.016) and median postoperative hospital stay (13 vs. 17 days, p=0.005) were significantly less in the prehepatectomy chemotherapy group.

Conclusion: Hepatic resection after prehepatectomy chemotherapy for patients with marginally resectable CRC liver metastases can lead to favorable short-term outcomes.

Keywords: Metastatic colorectal cancer; prehepatectomy chemotherapy.