Published online Sep 27, 2022. doi: 10.4240/wjgs.v14.i9.904
Peer-review started: March 3, 2022
First decision: April 19, 2022
Revised: April 28, 2022
Accepted: August 26, 2022
Article in press: August 26, 2022
Published online: September 27, 2022
Neoadjuvant chemotherapy (NC) improves the survival outcomes of selected patients with colorectal liver metastasis (CRLM). The benefits of irinotecan-based regimens in these patients are still under debate.
To compare the benefits of irinotecan- and oxaliplatin-based regimens in patients with resectable CRLM.
From September 2003 to August 2020, 554 patients received NC and underwent hepatectomy for CRLM. Based on a 1:1 propensity score matching (PSM) model, 175 patients who received irinotecan were matched to 175 patients who received oxaliplatin to obtain two balanced groups regarding demographic, therapeutic, and prognostic characteristics.
Chemotherapy was based on oxaliplatin in 353 (63.7%) patients and irinotecan in 201 (36.3%). After PSM, the 5-year progression-free survival (PFS) and overall survival (OS) rates with irinotecan were 18.0% and 49.7%, respectively, while the 5-year PFS and OS rates with oxaliplatin were 26.0% and 46.8%, respectively. Intraoperative blood loss, operating time, and postoperative complications dif
In NC in patients with CRLM, irinotecan is similar to oxaliplatin in survival outcomes, but irinotecan is superior regarding operating time, intraoperative blood loss, and postoperative complications.
Core Tip: This was the first retrospective cohort study to investigate irinotecan-based regimens for neoadjuvant chemotherapy in patients with colorectal liver metastasis (CRLM) in China. It highlighted the benefits of irinotecan and might contribute to modifying the treatment guidelines for CRLM. Che