Liu W, Chen FL, Wang K, Bao Q, Wang HW, Jin KM, Xing BC. Irinotecan- vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients: A retrospective study. World J Gastrointest Surg 2022; 14(9): 904-917 [PMID: 36185567 DOI: 10.4240/wjgs.v14.i9.904]
Corresponding Author of This Article
Bao-Cai Xing, Department of Hepatopancreatobiliary Surgery, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. xingbaocai88@sina.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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/
World J Gastrointest Surg. Sep 27, 2022; 14(9): 904-917 Published online Sep 27, 2022. doi: 10.4240/wjgs.v14.i9.904
Irinotecan- vs oxaliplatin-based regimens for neoadjuvant chemotherapy in colorectal liver metastasis patients: A retrospective study
Wei Liu, Feng-Lin Chen, Kun Wang, Quan Bao, Hong-Wei Wang, Ke-Min Jin, Bao-Cai Xing
Wei Liu, Feng-Lin Chen, Department of Hepatopancreatobiliary Surgery, Peking University School of Oncology, Beijing Cancer Hospital, Beijing 100142, China
Kun Wang, Quan Bao, Hong-Wei Wang, Ke-Min Jin, Bao-Cai Xing, Department of Hepatopancreatobiliary Surgery, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Liu W designed and performed the research and wrote the paper; Xing BC designed the research and supervised the report; Chen FL designed the research and contributed to the analysis; Wang K, Bao Q, Wang HW, and Jin KM provided clinical advice and reviewed the manuscript; and all authors have read and approved the final version.
Supported bythe National Nature Science Foundation of China, No. 81874143 and No. 31971192; and Beijing Hospitals Authority Youth Program, No. QMS20201105.
Institutional review board statement: The investigation project has been examined and certified by the Ethics Committee of Beijing Cancer Hospital (No. 2021YJZ06). The study was performed in accordance with the Declaration of Helsinki.
Informed consent statement: The present study is a retrospective study, and the requirement for individual consent was waived by the ethics committee.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Cai Xing, Department of Hepatopancreatobiliary Surgery, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. xingbaocai88@sina.com
Received: March 3, 2022 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 Processing time: 203 Days and 4.5 Hours
Abstract
BACKGROUND
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.
AIM
To compare the benefits of irinotecan- and oxaliplatin-based regimens in patients with resectable CRLM.
METHODS
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.
RESULTS
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 differed significantly between the two groups. In the multivariable analysis, carbohydrate antigen 19-9, RAS mutation, response to NC, tumor size > 5 cm, and tumor number > 1 were independently associated with PFS.
CONCLUSION
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. Chemotherapy was based on oxaliplatin in 353 (63.7%) patients and irinotecan in 201 (36.3%). After propensity score matching, 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.
