| International Session (Symposium) 7 (JSGS・JSGE・JSH) |
| Sat. November 3rd 14:00 - 17:00 Room 4: Portopia Hotel South Wing Portopia Hall |
| Treatment strategy for unresectable colorectal liver metastases: Clinical impact of FOLFOXIRI regimen | |||
| Yuji Morine1, Satoru Imura1, Mitsuo Shimada1 | |||
| 1Department of Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School | |||
|
|||
|
|||
| Background Recent advances in systemic chemotherapy, including molecular target agents, can be used to introduce “Conversion surgery” and achieve R0 resection in patients with unresectable colorectal liver metastasis (CRLM). In this study, we investigated treatment strategy for unresectable CRLM. Methods Our current surgical indication for CRLM as follows: i) curative resection, ii) no limitation of tumor size and number, and iii) future remnant liver volume over 35%. Two hundreds sixty-one patients from 1994 to 2015 were experienced. Among those, 52 unresectable CRLM, received current chemotherapy such as FOLFOX, FOLFILI IRIS, XEROX and FOLFOXIRI, were analyzed. Results Of those unresectable cases, conversion surgery could be introduced in 26 cases (50%). Logistic regression analysis revealed that conversion group indicated high frequency of less than MDN70 and liver limited disease, and those cases with FOLFOXIRI could be predicted 96.7% of conversion rate. Also, among conversion cases, more than 50% of tumor necrotic rate induced better postoperative survival. FOLFOXIRI was applied in 18 cases (34.6%). The “Conversion” rate of FOLFIXIRI and other regimen were 72.2% and 38.2% (p=0.0197), and median period until “Conversion” were 5.9 courses and 13.7 courses (p=0.038), respectively. Regarding tumor necrotic rate, FOLFOXIRI induced higher necrotic rate compared to other regimen (77.9% vs. 50.4%, p=0.0066). Overall survival in FOLFOXIRI has been better than that in other regimen and 3-years survival rates were 82.5% and 53.8%, respectively (p=0.0067). Conclusion FOLFOXIRI plus molecular target drug may be a promising option for CRLM with less than MDN70 and liver limited disease. |
|||
|
Index Term 1: unresectable colorectal liver metastasis Index Term 2: Conversion surgery |
|||
| Page Top | |||