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Updated: Jan 16, 2026
Application of Laparoscopic Hepatectomy Combined with Intraoperative Microwave Ablation in Colorectal Cancer Liver Metastasis
Published on: March 3, 2023
Neoadjuvant Chemotherapy for Initially Resectable Metachronous Colorectal Cancer Liver Metastases Is Associated With
Hiroyuki Takahashi1, Daibo Kojima2, Yoshihiro Miyasaka2
1Department of Surgery, Fukuoka University Chikushi Hospital, Fukuoka, Japan bjackfdh@adm.fukuoka-u.ac.jp.
Background/Aim:
The role of neoadjuvant chemotherapy (NAC) in treating initially resectable colorectal cancer liver metastases (CRCLM) remains controversial.
Patients And Methods:
We retrospectively compared outcomes between patients who underwent upfront surgery and those who received NAC followed by curative CRCLM surgery. Factors associated with early relapse were also investigated. Fifty-three patients were included (upfront surgery: n=31, NAC: n=22).
Results:
The 3-year overall survival (OS) and relapse-free survival (RFS) rates were comparable between the upfront surgery and NAC groups [OS: 83.9% vs. 81.8%, p=0.9, hazard ratio (HR)=1.07; RFS: 58.1% vs. 36.4%, p=0.1, HR=1.87]. However, among metachronous CRCLM cohorts, the 3-year OS rates were 88.2% and 90.0% (p=0.9, HR=0.85), and the 3-year RFS rates were 76.4% and 30.0% (p=0.015, HR=4.03), respectively. Patients with higher computed tomography values in CRCLM had significantly better RFS than those with lower values (p=0.04). Conversely, a higher number of CRCLM after NAC was significantly correlated with shorter RFS (p=0.007).
Conclusion:
Routine NAC for initially resectable metachronous CRCLM should be avoided because of the high risk of early relapse.
