Authors:	Moehler, Markus Folprecht, Gunnar Heinemann, Volker Holch, Julian Walter Maderer, Annett Kasper, Stefan Hegewisch-Becker, Susanna Schröder, Jan Overkamp, Friedrich Kullmann, Frank Bechstein, Wolf Otto Vöhringer, Matthias Öllinger, Robert Lordick, Florian Geißler, Michael Schulz-Abelius, Armin Linz, Bernhard Bernhard, Helga Paul, Andreas Schmidtmann, Irene Potthoff, Karin Schimanski, Carl Christoph
Title:	Survival after secondary liver resection in metastatic colorectal cancer : comparing data of three prospective randomized European trials (LICC, CELIM, FIRE-3)
Online publication date:	5-Sep-2022
Year of first publication:	2022
Language:	english
Abstract:	Metastatic colorectal cancer (mCRC) patients with liver-limited disease (LLD) have a chance of long-term survival and potential cure after hepatic metastasectomy. However, the appropriate postoperative treatment strategy is still controversial. The CELIM and FIRE-3 studies demonstrated that secondary hepatic resection significantly improved overall survival (OS). The objective of this analysis was to compare these favorable outcome data with recent results from the LICC trial investigating the antigen-specific cancer vaccine tecemotide (L-BLP25) as adjuvant therapy in mCRC patients with LLD after R0/R1 resection. Data from mCRC patients with LLD and secondary hepatic resection from each study were analyzed for efficacy outcomes based on patient characteristics, treatment and surveillance after surgery. In LICC, 40/121 (33%) patients, in CELIM 36/111 (32%) and in FIRE-3-LLD 29/133 (22%) patients were secondarily resected, respectively. Of those, 31 (77.5%) patients in LICC and all patients in CELIM were R0 resected. Median disease-free survival after resection was 8.9 months in LICC, 9.9 months in CELIM. Median OS in secondarily resected patients was 66.1 months in LICC, 53.9 months in CELIM and 56.2 months in FIRE-3-LLD. Median age was about 5 years less in LICC compared to CELIM and FIRE-3. Secondarily resected patients of LICC, CELIM and FIRE-3 showed an impressive median survival with a tendency for improved survival for patients in the LICC trial. A younger patient cohort but also more selective surgery, improved resection techniques, deep responses and a close surveillance program after surgery in the LICC trial may have had a positive impact on survival. What's new? The management of liver-limited disease (LLD) in patients with metastatic colorectal cancer (mCRC) is controversial, the optimal treatment has not been defined. Here, data from mCRC patients with LLD and secondary hepatic resection from the prospective randomized trials CELIM, FIRE-3 and LICC were compared. Secondarily resected patients from these trials showed an impressive overall survival (OS), with a tendency for improved OS in LICC. Reasons might be the deep response induced by chemotherapy and surgery combined with close surveillance after surgery. Further prospective, randomized clinical trials are strongly needed to clarify these benefits.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-7677
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY-NC-ND
Information on rights of use:	https://creativecommons.org/licenses/by-nc-nd/4.0/
Journal:	International journal of cancer 150 8
Pages or article number:	1341 1349
Publisher:	Wiley-Liss
Publisher place:	Bognor Regis
Issue date:	2022
ISSN:	1097-0215
Publisher DOI:	10.1002/ijc.33881
Appears in collections:	JGU-Publikationen