Response to neo-adjuvant chemotherapy for colorectal liver metastasis of cancer: a key to improving the survival?

R. Bertani Chiappa, e., r. Biffi, u. peace

Liver Resection in colorectal cancer metastatic disease offers the best chance in cases selected for the long-term survival. Intravenous pyelogram (NACT) Chemotherapy was supported in some cases initially deemed irresectable, with few reports the effectiveness of this strategy and the influence of chemoresponsiveness on the outcome of radical liver resection. Methodology: Between December 1995 and 27 patients with colorectal liver metastases, May 2005 (7 20 females, males, mean age: 58 8 years; range: 40-75) were treated with chemotherapy neoadjuvant chemotherapy.You performed a survival analysis of 7 years. Chemotherapy included mainly 5-fluorouracil, leucovorin and Oxaliplatin and irinotecan to a median of 8 courses.

Sixteen patients (59%) had synchronous and 11 metastasis metachronous (41%). during the regression of cancer chemotherapy pre that occurred in 10 cases (37%); stable disease (SD) in a further 10 patients (37%) and the progressive disease (PD) developed in 7 cases (26%). Year 5 General survival for NACT responders was 64% and only 15% for non-responders (p = 0.044).

The response to chemotherapy is likely to be a significant prognostic factor affecting the survival after liver resection for care.

Volume: 1 article number: 58 DOI: 10.3332/ecancer. 2008 58 received: 20/08/2007 published: 16/10/2007

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Institutional guidelines and ongoing studies in the management of liver tumors: the experience of the European Institute of Oncology

Zampino by m.g. Biffi, f. bears, r. r. Chiappa, n. Funk, f. De Braud, Bonomo g., l. Monfardini, p. Della Vigna, f. Luke, l. Bodei, m. Bartolomei, g. Catalano, M.C. Leonardi, m. Ferrari, b. Andreoni, r. g. Goldhirsch, Paganelli, r. Orecchia

Background:
A task force on upper gastrointestinal cancers institutional is active at the European Institute of Oncology (IEO). Members decided to gather in a document of institutional guidelines on managing liver tumors (primary and metastatic). This article is intended to present the current treatment guidelines and protocols of ongoing research and experiments in this field at IEO.

Methods:
A Steering Committee is convened to assign tasks to individual members. expert Contributions in every area of treatment were collected in a single document in order to produce a draft for later review by the aforementioned Committee. Six drafts discussed and approved the final version.

Results:
Surgical, medical oncology approaches, Interventional Radiology, nuclear medicine and radiotherapy, their roles in the management of hepatic tumors and ongoing research trials are presented and discussed in this article.

Conclusions:
At the European Institute of Oncology, a multidisciplinary and integrated approach for liver tumors is a standard and many ongoing research projects are currently active in this field.

Volume: 2 article number: 64 DOI: 10.3332/eCMS. 2008.64 received: 28/12/2007 published: 02/05/2008

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