Optimizing adjuvant therapy after surgery for colorectal cancer liver metastases: A systematic review

Postgraduate Thesis uoadl:3298455 49 Read counter

Unit:
Κατεύθυνση Κλινικές Μελέτες: Σχεδιασμός και Εκτέλεση
Library of the School of Health Sciences
Deposit date:
2023-03-14
Year:
2023
Author:
Georgilis Emmanouil
Supervisors info:
Ντάνασης-Σταθόπουλος Ιωάννης, PhD Ιατρός, Ιατρική Σχολή, ΕΚΠΑ
Γαβριατοπούλου Μαρία, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Θεοδοσόπουλος Θεοδόσιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Βελτιστοποίηση της επικουρικής θεραπείας μετά από τη χειρουργική εκτομή των ηπατικών μεταστάσεων του καρκίνου του παχέος εντέρου: Συστηματική ανασκόπηση
Languages:
Greek
Translated title:
Optimizing adjuvant therapy after surgery for colorectal cancer liver metastases: A systematic review
Summary:
Objectives
Liver is the most common site of colorectal cancer metastatic spread. Although metastasectomy is the gold standard for fit patients with resectable colorectal cancer liver metastases (CRLM), their management after surgical treatment remains controversial. The objective of this systematic review was to collate the currently available data of the agents used in the adjuvant setting in order to define the most optimal therapeutic strategy.
Methods and materials
A systematic review of literature was conducted by searching Pubmed/Medline and Cohrane library databases. We included studies that evaluated the efficacy, the tolerability and the safety profile of various chemotherapeutic agents that are used as adjuvant treatment after surgical resection of CRLM. The outcomes of interest were regression-free survival (RFS), disease-free survival (DFS), overall survival (OS) and severe toxicities.
Results
From 543 initial articles, 29 publications with 7028 patients were finally included. In general, the results of the eligible studies indicated that the adjuvant therapy after resection of CRLM led to improved RFS/DFS rates, but this benefit did not contribute to a statistically significant prolongation of OS. Moreover, the choice of the therapeutic strategy, namely systematic or regional chemotherapy or the combination of both, did not seem to have a differential impact on patient outcomes. However, these results should be interpeted with caution since the majority of the chosen studies are of low or moderate quality.
Conclusions
In this context, further high-quality clinical trials conducted on patient sub-populations with modern therapies are required in order to reduce in-study and between-study heterogeneity and determine which patients are expected to derive the maximum benefit from adjuvant therapy after surgery for CRLM.
Main subject category:
Health Sciences
Keywords:
Colorectal cancer liver metastases, Liver metastasectomy, Adjuvant therapy, Systematic Chemotherapy, Hepatic arterial infusion chemotherapy, Systematic review
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
76
Number of pages:
53
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