| Abstrakt: |
Aim: To compare the differences between neoadjuvant chemotherapy with resection and upfront surgery for patients with resectable colorectal cancer with liver metastases. Patients and Methods: The following electronic databases were searched for systematic literature: PubMed, Cochrane Library and Google Scholar. Studies fulfilling the following criteria were included in the analysis: compared neoadjuvant chemotherapy and upfront surgery; included patients with resectable metastases at the time of presentation; reported the long‐term results, including overall survival (OS) and disease‐free survival (DFS); and identified early adverse postoperative events, including 30‐day mortality and overall postoperative complications. Results: Over 24 studies with 8700 patients were analysed. Patients were divided into the neoadjuvant chemotherapy group (n = 3490, 40.1%) and the upfront surgery group (n = 5172, 59.4%). The meta‐analysis showed no statistically significant difference in terms of overall morbidities [odds ratio (OR) 1.19, 95% confidence interval (CI) 0.84‐1.67] and mortality (OR 1.48, 95% CI 0.75‐2.92) between the neoadjuvant chemotherapy and upfront surgery groups. However, the meta‐analysis showed a favourable OS in the upfront surgery group (OR 1.21, 95% CI 1.06‐1.38) and favourable DFS in the upfront surgery group (OR 1.71, 95% CI 1.38‐2.12), including the subgroups of 1‐, 3‐, 5‐year DFS (OR 1.38, 95% CI 1.06‐1.8; OR 2.06, 95% CI 1.35‐3.14 and OR 1.65, 95% CI 1.18‐2.29, respectively). Conclusion: Neoadjuvant chemotherapy has no benefit for resectable colorectal cancer with liver metastases; therefore, upfront surgery should be considered as the treatment of choice. [ABSTRACT FROM AUTHOR] |
Plný text