Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983)

Sorbye, Halfdan, Mauer, Murielle, Gruenberger, Thomas, Glimelius, Bengt, Poston, Graeme J., Schlag, Peter M., Rougier, Philippe, Bechstein, Wolf O., Primrose, John N., Walpole, Euan T., Finch-Jones, Meg, Jaeck, Daniel, Mirza, Darius, Parks, Rowan W., Collette, Laurence, Van Cutsem, Eric, Scheithauer, Werner, Lutz, Manfred P., Nordlinger, Bernard, for the EORTC Gastro-Intestinal Tract Canc, EORTC Gastro-Intestinal Tract Cancer Group, Cancer Research UK (CRUK), Arbeitsgruppe Lebermetastasen undtumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO), Australasian Gastro-Intestinal Trials Group (AGITG) and Fédération Francophone de Cancérologie Digestive (FFCD) (2012) Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983). Annals of Surgery, 255 3: 534-539. doi:10.1097/SLA.0b013e3182456aa2


Author Sorbye, Halfdan
Mauer, Murielle
Gruenberger, Thomas
Glimelius, Bengt
Poston, Graeme J.
Schlag, Peter M.
Rougier, Philippe
Bechstein, Wolf O.
Primrose, John N.
Walpole, Euan T.
Finch-Jones, Meg
Jaeck, Daniel
Mirza, Darius
Parks, Rowan W.
Collette, Laurence
Van Cutsem, Eric
Scheithauer, Werner
Lutz, Manfred P.
Nordlinger, Bernard
for the EORTC Gastro-Intestinal Tract Canc
EORTC Gastro-Intestinal Tract Cancer Group, Cancer Research UK (CRUK)
Arbeitsgruppe Lebermetastasen undtumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO)
Australasian Gastro-Intestinal Trials Group (AGITG)
Fédération Francophone de Cancérologie Digestive (FFCD)
Title Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983)
Journal name Annals of Surgery   Check publisher's open access policy
ISSN 0003-4932
1528-1140
Publication date 2012-03-01
Sub-type Article (original research)
DOI 10.1097/SLA.0b013e3182456aa2
Volume 255
Issue 3
Start page 534
End page 539
Total pages 6
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
OBJECTIVE:
In EORTC study 40983, perioperative FOLFOX increased progression-free survival (PFS) compared with surgery alone for patients with initially 1 to 4 resectable liver metastases from colorectal cancer (CRC). We conducted an exploratory retrospective analysis to identify baseline factors possibly predictive for a benefit of perioperative FOLFOX on PFS.

METHODS:
The analysis was based on 237 events from 342 eligible patients. Cox proportional hazards regression models with a significance level of 0.1 were used to build up univariate and multivariate models.

RESULTS:
After adjustment for identified prognostic factors, moderately (5.1-30 ng/mL) and highly (>30 ng/mL) elevated carcinoembryonic antigen (CEA) serum levels were both predictive for the benefit of perioperative chemotherapy (interaction P = 0.07; hazard ratio [HR] = 0.58 and HR = 0.52 for treatment benefit). For patients with moderately or highly elevated CEA (>5 ng/mL), the 3-year PFS was 35% with perioperative chemotherapy compared to 20% with surgery alone. Performance status (PS) 0 and BMI lower than 30 were also predictive for the benefit of perioperative chemotherapy (interaction P = 0.04 and P = 0.02). However, the number of patients with PS 1 and BMI 30 or higher were limited. The benefit of perioperative therapy was not influenced by the number of metastatic lesions (1 vs 2-4, interaction HR = 0.98).

CONCLUSIONS:
Perioperative FOLFOX seems to benefit in particular patients with resectable liver metastases from CRC when CEA is elevated and when PS is unaffected, regardless of the number of metastatic lesions.
Keyword III Colon-Cancer
Adjuvant Chemotherapy
Stage-II
1st-Line Chemotherapy
Hepatic Resection
Survival
Oxaliplatin
Recommendations
Fluorouracil
Leucovorin
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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