Impact of Additive Chemotherapy on Survival in Stage IV Colon Cancer Patients Following Liver Metastasectomy: A Retrospective Analysis with a Focus on Chemotherapy Regime Efficacy

Introduction: The use of additive chemotherapy following R0 liver metastasectomy is a topic surrounded by controversy. This study aims to investigate the impact of adjuvant chemotherapy on overall survival (OS).

Methods: This monocentric study at the University Hospital Regensburg investigated whether additive chemotherapy provides a survival benefit for patients over the age of 18 years with adenocarcinoma or mucinous carcinoma of the colon and synchronous or metachronous liver metastases following R0 resection. Secondary endpoints included progression-free survival (PFS) and the occurrence of adverse events.

Results: 171 patients were enrolled. 65 received adjuvant chemotherapy, and 106 did not. Both groups showed no significant differences regarding sex, risk factors, or tumor characteristics. However, the chemotherapy group was significantly younger (61 vs. 68 years, p=0.002). OS did not differ significantly between groups (median: 62.9 months vs. 55.9 months, p=0.323). Similarly, no significant difference was observed in PFS (median: 30.4 months vs. 23.7 months, p=0.157). Subgroup analysis revealed that patients receiving capecitabine (n=17) exhibited a significantly superior OS (median: 90 months) compared to those receiving FOLFOX (n=40, median: 31 months, p=0.014). PFS showed no significant difference (median: 14 vs. 12 months, p=0.446). There were no significant differences in adverse events between the groups, though the chemotherapy group experienced more fatigue, constipation, and diarrhea, while thrombocytopenia and leukopenia were more common in the control group.

Conclusion: The study suggests that additive chemotherapy does not significantly improve OS in patients with colorectal cancer following liver metastasectomy, though capecitabine appears superior to FOLFOX.

Publication History

Article published online:
20 January 2025