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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2016; 22(2): 519-533
Published online Jan 14, 2016. doi: 10.3748/wjg.v22.i2.519
Adjuvant chemotherapy for resected colorectal cancer metastases: Literature review and meta-analysis
Giovanni Brandi, Stefania De Lorenzo, Margherita Nannini, Stefania Curti, Marta Ottone, Filippo Gustavo Dall’Olio, Maria Aurelia Barbera, Maria Abbondanza Pantaleo, Guido Biasco
Giovanni Brandi, Maria Abbondanza Pantaleo, Guido Biasco, Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola-Malpighi Hospital and “G. Prodi” Interdepartmental Center for Cancer Research, Bologna University, 40138 Bologna, Italy
Stefania De Lorenzo, Margherita Nannini, Filippo Gustavo Dall’Olio, Maria Aurelia Barbera, Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
Stefania Curti, Marta Ottone, Department of Medical and Surgical Sciences, Bologna University, 40138 Bologna, Italy
Author contributions: All authors have been involved in drafting the manuscript, and read and approved the final version.
Conflict-of-interest statement: The authors have no conflict of interest and no financial support to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giovanni Brandi, MD, PhD, Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola-Malpighi Hospital and “G. Prodi” Interdepartmental Center for Cancer Research, Bologna University, via Massarenti 9, 40138 Bologna, Italy. giovanni.brandi@unibo.it
Telephone: +39-51-6363838 Fax: +39-51-6364536
Received: May 29, 2015
Peer-review started: June 3, 2015
First decision: September 11, 2015
Revised: October 6, 2015
Accepted: November 13, 2015
Article in press: November 13, 2015
Published online: January 14, 2016
Processing time: 222 Days and 10.6 Hours
Abstract

Surgical resection is the only option of cure for patients with metastatic colorectal cancer (CRC). However, the risk of recurrence within 18 mo after metastasectomy is around 75% and the liver is the most frequent site of relapse. The current international guidelines recommend an adjuvant therapy after surgical resection of CRC metastases despite the lower level of evidence (based on the quality of studies in this setting). However, there is still no standard treatment and the effective role of an adjuvant therapy remains controversial. The aim of this review is to report the state-of-art of systemic chemotherapy and regional chemotherapy with hepatic arterial infusion in the management of patients after resection of metastases from CRC, with a literature review and meta-analysis of the relevant randomized controlled trials.

Keywords: Liver metastases; Adjuvant chemotherapy; Metastasectomy; Colorectal cancer; Adjuvant hepatic artery infusion

Core tip: Surgical resection is the only option of cure for patients with metastatic colorectal cancer (CRC). The risk of recurrence within 18 mo after metastasectomy is about 75% and the liver is the main organ involved. However, there is still no standard treatment and the effective role of adjuvant therapy remains controversial. The aim of this review is to summarize current knowledge on the role of systemic chemotherapy and regional chemotherapy with hepatic arterial infusion in the management of patients after resection of metastases from CRC.