Universität zu Köln

Garlipp, B., Gibbs, P., Van Hazel, G. A., Jeyarajah, R., Martin, R. C. G., Bruns, C. J., Lang, H., Manas, D. M., Ettorre, G. M., Pardo, F., Donckier, V., Benckert, C., van Gulik, T. M., Goere, D., Schoen, M., Pratschke, J., Bechstein, W. O., de la Cuesta, A. M., Adeyemi, S., Ricke, J. and Seidensticker, M. (2019). Secondary technical resectability of colorectal cancer liver metastases after chemotherapy with or without selective internal radiotherapy in the randomized SIRFLOX trial. Br. J. Surg., 106 (13). S. 1837 - 1847. HOBOKEN: WILEY. ISSN 1365-2168

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Abstract

Background: Secondary resection of initially unresectable colorectal cancer liver metastases (CRLM) can prolong survival. The added value of selective internal radiotherapy (SIRT) to downsize lesions for resection is not known. This study evaluated the change in technical resectability of CRLM with the addition of SIRT to FOLFOX-based chemotherapy. Methods: Baseline and follow-up hepatic imaging of patients who received modified FOLFOX (mFOLFOX6: fluorouracil, leucovorin, oxaliplatin) chemotherapy with or without bevacizumab (control arm) versus mFOLFOX6 (with or without bevacizumab) plus SIRT using yttrium-90 resin microspheres (SIRT arm) in the phase III SIRFLOX trial were reviewed by three or five (of 14) expert hepatopancreatobiliary surgeons for resectability. Reviewers were blinded to one another, treatment assignment, extrahepatic disease status, and information on clinical and scanning time points. Technical resectability was defined as at least 60 per cent of reviewers (3 of 5, or 2 of 3) assessing a patient's liver metastases as surgically removable. Results: Some 472 patients were evaluable (SIRT, 244; control, 228). There was no significant baseline difference in the proportion of technically resectable liver metastases between SIRT (29, 11.9 per cent) and control (25, 11.0 per cent) arms (P = 0.775). At follow-up, significantly more patients in both arms were deemed technically resectable compared with baseline: 159 of 472 (33.7 per cent) versus 54 of 472 (11.4 per cent) respectively (P = 0.001). More patients were resectable in the SIRT than in the control arm: 93 of 244 (38.1 per cent) versus 66 of 228 (28.9 per cent) respectively (P < 0.001). Conclusion: Adding SIRT to chemotherapy may improve the resectability of unresectable CRLM.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Garlipp, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gibbs, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Van Hazel, G. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jeyarajah, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Martin, R. C. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, C. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Manas, D. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ettorre, G. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pardo, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Donckier, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Benckert, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED van Gulik, T. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Goere, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoen, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pratschke, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bechstein, W. O. UNSPECIFIED UNSPECIFIED UNSPECIFIED de la Cuesta, A. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Adeyemi, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ricke, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seidensticker, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-126239
DOI:	10.1002/bjs.11283
Journal or Publication Title:	Br. J. Surg.
Volume:	106
Number:	13
Page Range:	S. 1837 - 1847
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1365-2168
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RADIATION-THERAPY; HEPATIC RESECTION; CETUXIMAB; SURGERY; TERM; RADIOEMBOLIZATION; BEVACIZUMAB; SURVIVAL; ABLATION; DISEASE Multiple languages Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12623