[Conversion therapy for synchronous colorectal liver metastases]

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Context:

• Colorectal liver metastases (CRLM) present a significant clinical challenge, often unresectable at diagnosis.
• Conversion therapy, involving chemotherapy to downstage tumors, is an emerging strategy for managing unresectable CRLM.
• Synchronous CRLM, diagnosed concurrently with the primary tumor, requires tailored treatment approaches.

Purpose:

• To evaluate the applicability and outcomes of conversion therapy for unresectable colorectal liver metastases (CRLM) in a real-world clinical setting.
• To compare the survival rates of patients with synchronous CRLM treated with conversion therapy versus upfront hepatectomy for resectable disease.
• To identify factors influencing the success of conversion therapy and inform future treatment strategies.

Summary:

• This study retrospectively analyzed 93 patients with synchronous CRLM, with 12 undergoing conversion therapy.
• The primary chemotherapy regimen for conversion therapy involved oxaliplatin-based multidrug therapy (67% of cases), with 3 to 24 courses administered.
• Conversion therapy resulted in a 46% 5-year survival rate, statistically similar to the survival rate observed in patients undergoing direct hepatectomy for initially resectable CRLM.
• No significant differences in clinicopathological factors were noted between patients who did and did not undergo conversion therapy.

Impact:

• Conversion therapy demonstrates potential as an effective strategy to improve outcomes for patients with initially unresectable CRLM.
• Expanding the use of effective chemotherapy regimens for conversion therapy could enhance survival rates in synchronous CRLM.
• Further research is needed to optimize the balance between chemotherapy and hepatectomy in the management of CRLM.