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Adjuvant intra-arterial chemotherapy for patients with resected colorectal liver metastases: a systematic review and meta-analysis.
Buisman, Florian E; Filipe, Wills F; Galjart, Boris; Grünhagen, Dirk J; Homs, Marjolein Y V; Moelker, Adriaan; Verhoef, Cornelis; Groot Koerkamp, Bas.
Afiliación
  • Buisman FE; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, the Netherlands.
  • Filipe WF; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, the Netherlands.
  • Galjart B; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, the Netherlands.
  • Grünhagen DJ; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, the Netherlands.
  • Homs MYV; Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, the Netherlands.
  • Moelker A; Department of Radiology and Nuclear Medicine, Erasmus MC, Erasmus University, Rotterdam, the Netherlands.
  • Verhoef C; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, the Netherlands.
  • Groot Koerkamp B; Department of Surgery, Erasmus MC Cancer Institute, Erasmus University, Rotterdam, the Netherlands. Electronic address: b.grootkoerkamp@erasmusmc.nl.
HPB (Oxford) ; 24(3): 299-308, 2022 03.
Article en En | MEDLINE | ID: mdl-34895829
BACKGROUND: The practice of adjuvant hepatic arterial infusion chemotherapy (HAIC) for colorectal liver metastasis (CRLM) varies widely. This meta-analysis investigates the effectiveness of adjuvant HAIC and the influence of variations in HAIC treatment in patients with resected CRLM. METHODS: PRISMA guidelines were followed for this study. The search was limited to comparative studies (HAIC vs non-HAIC) for overall survival. Subgroup meta-analyses using random-effects were performed for type of intra-arterial drug, method of catheter insertion, use of concomitant adjuvant systemic chemotherapy, and study design. RESULTS: Eighteen eligible studies were identified. After excluding overlapping cohorts, fifteen studies were included in the quantitative analysis, corresponding to 3584 patients. HAIC was associated with an improved overall survival (pooled hazard ratio (HR) 0.77; 95%CI 0.64-0.93). Survival benefit of HAIC was most pronounced in studies using floxuridine (HR 0.76; 95%CI: 0.62-0.94), surgical catheter insertion with subcutaneous pump (HR 0.71; 95%CI: 0.61-0.84), and concomitant adjuvant systemic chemotherapy (HR 0.75; 95%CI: 0.59-0.96). The pooled HR of RCTs was 0.91 (95%CI 0.72-1.14), of which only 3 used floxuridine. CONCLUSION: Adjuvant HAIC is a promising treatment for patients with resectable CRLM, in particular HAIC with floxuridine using a surgically placed catheter and a subcutaneous pump, and concomitant systemic chemotherapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Neoplasias Hepáticas Tipo de estudio: Guideline / Systematic_reviews Límite: Humans Idioma: En Revista: HPB (Oxford) Asunto de la revista: GASTROENTEROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Neoplasias Hepáticas Tipo de estudio: Guideline / Systematic_reviews Límite: Humans Idioma: En Revista: HPB (Oxford) Asunto de la revista: GASTROENTEROLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido