Long-Term Outcome of Unresectable Metastatic Colorectal Cancer: Does 'Adjuvant' Chemotherapy Play a Role After Resection?

摘要

We read with interest the article by the Gruppo Oncologico Nord Ovest (G.O.N.O) group titled "Long-term outcome of initially unresectable metastatic colorectal cancer patients treated with 5-flu-orouracil/leucovorin, oxaliplatin, and irinote-can (FOLFOXIRI) followed by radical surgery of metastases" published in the March 2009 issue of the Annals of Surgery. From a total population of 196 patients deemed unresectable, the overall resection rate was 19% and the 5- and 8-year survival rates of patients who had an R0 resection was 42% and 33%, respectively. This compares favorably with the largest retrospective series reporting a resection rate of 13.5%, and an overall survival rate of 39% with a similar follow-up period, in 701 patients with initially unresectable liver metastases. Most of patients in the current G.O.N.O article were treated in the context of a prospective phase III clinical trial, which further highlights the benefits of both the FOLFOXIRI regimen and surgical resection in this setting.