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Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983)

Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983)
Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983)
Objective: in EORTC study 40983, perioperative FOLFOX increased progression-free survival (PFS) compared with surgery alone for patients with initially 1 to 4 resectable liver metastases from colorectal cancer (CRC). We conducted an exploratory retrospective analysis to identify baseline factors possibly predictive for a benefit of perioperative FOLFOX on PFS.

Methods: the analysis was based on 237 events from 342 eligible patients. Cox proportional hazards regression models with a significance level of 0.1 were used to build up univariate and multivariate models.

Results: after adjustment for identified prognostic factors, moderately (5.1–30 ng/mL) and highly (>30 ng/mL) elevated carcinoembryonic antigen (CEA) serum levels were both predictive for the benefit of perioperative chemotherapy (interaction P = 0.07; hazard ratio [HR] = 0.58 and HR = 0.52 for treatment benefit). For patients with moderately or highly elevated CEA (>5 ng/mL), the 3-year PFS was 35% with perioperative chemotherapy compared to 20% with surgery alone. Performance status (PS) 0 and BMI lower than 30 were also predictive for the benefit of perioperative chemotherapy (interaction P = 0.04 and P = 0.02). However, the number of patients with PS 1 and BMI 30 or higher were limited. The benefit of perioperative therapy was not influenced by the number of metastatic lesions (1 vs 2–4, interaction HR = 0.98).

Conclusions: perioperative FOLFOX seems to benefit in particular patients with resectable liver metastases from CRC when CEA is elevated and when PS is unaffected, regardless of the number of metastatic lesions
0003-4932
534-539
Sorbye, Halfdan
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Mauer, Murielle
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Gruenberger, Thomas
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Glimelius, Bengt
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Poston, Graeme J.
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Schlag, Peter M.
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Rougier, Philippe
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Bechstein, Wolf O.
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Primrose, John N.
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Walpole, Euan T
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Finch-Jones, Meg
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Jaeck, Daniel
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Mirza, Darius
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Parks, Rowan W.
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Collette, Laurence
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Van Cutsem, Eric
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Scheithauer, Werner
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Lutz, Manfred P.
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Nordlinger, Bernard
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Sorbye, Halfdan
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Mauer, Murielle
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Gruenberger, Thomas
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Glimelius, Bengt
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Poston, Graeme J.
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Schlag, Peter M.
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Rougier, Philippe
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Bechstein, Wolf O.
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Primrose, John N.
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Walpole, Euan T
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Finch-Jones, Meg
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Jaeck, Daniel
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Mirza, Darius
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Parks, Rowan W.
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Collette, Laurence
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Van Cutsem, Eric
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Scheithauer, Werner
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Lutz, Manfred P.
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Nordlinger, Bernard
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Sorbye, Halfdan, Mauer, Murielle, Gruenberger, Thomas, Glimelius, Bengt, Poston, Graeme J., Schlag, Peter M., Rougier, Philippe, Bechstein, Wolf O., Primrose, John N., Walpole, Euan T, Finch-Jones, Meg, Jaeck, Daniel, Mirza, Darius, Parks, Rowan W., Collette, Laurence, Van Cutsem, Eric, Scheithauer, Werner, Lutz, Manfred P. and Nordlinger, Bernard (2012) Predictive factors for the benefit of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC Intergroup Trial 40983). Annals of Surgery, 255 (3), 534-539. (doi:10.1097/SLA.0b013e3182456aa2). (PMID:22314329)

Record type: Article

Abstract

Objective: in EORTC study 40983, perioperative FOLFOX increased progression-free survival (PFS) compared with surgery alone for patients with initially 1 to 4 resectable liver metastases from colorectal cancer (CRC). We conducted an exploratory retrospective analysis to identify baseline factors possibly predictive for a benefit of perioperative FOLFOX on PFS.

Methods: the analysis was based on 237 events from 342 eligible patients. Cox proportional hazards regression models with a significance level of 0.1 were used to build up univariate and multivariate models.

Results: after adjustment for identified prognostic factors, moderately (5.1–30 ng/mL) and highly (>30 ng/mL) elevated carcinoembryonic antigen (CEA) serum levels were both predictive for the benefit of perioperative chemotherapy (interaction P = 0.07; hazard ratio [HR] = 0.58 and HR = 0.52 for treatment benefit). For patients with moderately or highly elevated CEA (>5 ng/mL), the 3-year PFS was 35% with perioperative chemotherapy compared to 20% with surgery alone. Performance status (PS) 0 and BMI lower than 30 were also predictive for the benefit of perioperative chemotherapy (interaction P = 0.04 and P = 0.02). However, the number of patients with PS 1 and BMI 30 or higher were limited. The benefit of perioperative therapy was not influenced by the number of metastatic lesions (1 vs 2–4, interaction HR = 0.98).

Conclusions: perioperative FOLFOX seems to benefit in particular patients with resectable liver metastases from CRC when CEA is elevated and when PS is unaffected, regardless of the number of metastatic lesions

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Published date: March 2012
Organisations: Cancer Sciences

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Local EPrints ID: 339801
URI: https://eprints.soton.ac.uk/id/eprint/339801
ISSN: 0003-4932
PURE UUID: 5450daea-41d5-4cdb-aa71-e69cabd0f6cb
ORCID for John N. Primrose: ORCID iD orcid.org/0000-0002-2069-7605

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Date deposited: 31 May 2012 08:20
Last modified: 06 Jun 2018 13:06

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Contributors

Author: Halfdan Sorbye
Author: Murielle Mauer
Author: Thomas Gruenberger
Author: Bengt Glimelius
Author: Graeme J. Poston
Author: Peter M. Schlag
Author: Philippe Rougier
Author: Wolf O. Bechstein
Author: Euan T Walpole
Author: Meg Finch-Jones
Author: Daniel Jaeck
Author: Darius Mirza
Author: Rowan W. Parks
Author: Laurence Collette
Author: Eric Van Cutsem
Author: Werner Scheithauer
Author: Manfred P. Lutz
Author: Bernard Nordlinger

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