Addition of pre-and/or post-hepatectomy chemotherapy to liver resection was not associated with improved survival in patients with resectable colorectal liver metastases: IPTW analysis

Background: For patients with resectable colorectal liver metastases (CLM), the following 3 approaches are used: surgery alone, surgery+post-hepatectomy chemotherapy, and pre-hepatectomy chemotherapy+surgery. However, it remains unclear which approaches improve survival.
Methods: Patients undergoing CLM resection during 2005–2018 were included. Our group originally used surgery alone, and gradually adopted post-hepatectomy chemotherapy, and pre-hepatectomy chemotherapy for CLM ≧ 5. Inverse probability of treatment weighted (IPTW) analysis was used.
Results: Of the 439 patients, 175 underwent surgery alone, 135 underwent surgery+post-hepatectomy chemotherapy, and 129 underwent pre-hepatectomy chemotherapy+surgery. After IPTW adjustment, demographics were well balanced. The IPTW-adjusted overall survival and recurrence-free survival did not differ significantly between the groups (Figure 1).
Conclusion: The addition of chemotherapy did not improve survival, implying the reappraisal of multimodal approaches for resectable CLM.