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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.
Anticancer Research
|September 26, 2025
Summary
Neoadjuvant chemotherapy (NAC) for resectable colorectal cancer liver metastases (CRCLM) did not improve survival. Routine NAC for metachronous CRCLM is not recommended due to increased early relapse risk.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Neoadjuvant chemotherapy (NAC) for initially resectable colorectal cancer liver metastases (CRCLM) is controversial.
- Limited data exists on its impact on survival and relapse rates.
Purpose of the Study:
- To compare outcomes between upfront surgery and NAC followed by surgery for CRCLM.
- To identify factors associated with early relapse in CRCLM patients.
Main Methods:
- Retrospective study of 53 patients with resectable CRCLM.
- Comparison of upfront surgery (n=31) versus NAC followed by surgery (n=22).
- Analysis of overall survival (OS) and relapse-free survival (RFS).
Main Results:
- Overall survival and relapse-free survival were comparable between upfront surgery and NAC groups.
- Metachronous CRCLM patients receiving NAC showed significantly worse 3-year RFS (30.0% vs 76.4%, p=0.015).
- Higher CT values in CRCLM correlated with better RFS; increased CRCLM post-NAC correlated with shorter RFS.
Conclusions:
- Routine NAC for initially resectable metachronous CRCLM should be avoided.
- NAC may increase the risk of early relapse in this patient subgroup.
- Further research is needed to refine NAC strategies for CRCLM.
