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A meta-analysis of two randomized trials. Liwan has ca jobs listed on their profile. To be eligible for enrolment, patients had to be aged between 18 and 80 years with a WHO performance status of 2 or less, prroail proven colorectal cancer, one to four liver metastases that were potentially resectable, and no detectable extrahepatic tumour.
To address the lead-time bias that was inherent to the design, the event time to have occurred at 10 weeks was assigned in both treatment groups in the following circumstances: This document may be redistributed and reused, subject to certain conditions. PR has received travel grants, served on the advisory board, and consults for Sanofi-Aventis and Pfizer.
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National Cancer Institute Common toxicity criteria version 2. BN and LC had full access to all the data in the study. Liver resection for colorectal metastases: Control arm for surgery alone is needed but difficult to obtain in randomized trials for adjuvant chemotherapy after liver resection for colorectal metastases.
New guidelines to evaluate the response to treatment in solid tumors. When deemed unresectable or after recurrence, patients were treated at the physician’s discretion.
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Open in a separate window. Results Figure 1 shows the trial profile. We used intraoperative ultrasonography to detect and localise all hepatic metastases.
Thus, there remains a need for clear evidence for whether combined treatment with chemotherapy is better than surgery alone in patients with resectable liver metastases from colorectal cancer. Patients may have several complications, therefore number of complications does not add up to the total number of patients.
After preoperative chemotherapy mm 33 0 to Some trials used intrahepatic arterial infusion and others intravenous chemotherapy. The combination of targeted agents with cytotoxic therapy has shown high response rates 27—29 and thus warrants assessment in the perioperative setting.
No log was kept of the number of patients who were screened for eligibility. Figure 1 shows the trial profile.
After surgery we recorded two deaths in the surgery alone group and one in the perioperative chemotherapy group. None of these patients started the postoperative protocol chemotherapy.
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Previous studies of adjuvant chemotherapy in patients with resected liver metastases from colorectal cancer. Because of the specific objective in our trial, patients had to be randomly assigned imperatively before surgery—ie, without any certainty that metastases assessed by imaging were actually resectable. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. Clinical examination, chest radiography, abdomino-pelvic CT prirail with contrast medium spiral CT was recommended or MRI, electrocardiogram, and standard laboratory work-up were undertaken within 14 days of study entry.
Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer.
Similarly, the MAGIC trial showed that perioperative chemotherapy increases overall survival, whereas most trials of postoperative chemotherapy alone did not show a benefit. The complication rate was higher in the chemotherapy group than in the surgery group but was similar to other series of patients undergoing hepatectomy.
The primary objective of this trial was to assess perioperative chemotherapy in patients qualifying for resection of their metastatic disease. Karoui and colleagues 25 showed that the risk of surgical complications after preoperative chemotherapy is related to the number of chemotherapy cycles, and that this risk remains low if not more than six cycles are given preoperatively.
The content of this report is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. A All randomly assigned patients.