Is interval chemotherapy safe and does it improve the outcome of patients with colorectal liver metastases undergoing multimodal two-stage hepatectomy? – A systematic literature review

• Published in: BMC cancer Vol. 24; no. 1; pp. 1260 - 9
• Main Authors: Raschzok, Nathanael, Moosburner, Simon, Blank, Moritz, Krenzien, Felix, Lurje, Georg, Schöning, Wenzel, Sauer, Igor M., Pratschke, Johann, Modest, Dominik P., Kurreck, Annika
• Format: Journal Article
• Language: English
• Published: London BioMed Central 10.10.2024; BioMed Central Ltd; BMC
• Subjects: Ablation; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomedical and Life Sciences; Biomedicine; Cancer; Cancer Research; Cancer therapies; Care and treatment; Chemotherapy; Clinical trials; Colorectal cancer; Colorectal liver metastases; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Combined Modality Therapy; Development and progression; Disease control; Health Promotion and Disease Prevention; Hepatectomy; Hepatectomy - methods; Humans; Hypertrophy; Interval chemotherapy; Literature reviews; Liver; Liver diseases; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Medical research; Medicine, Experimental; Medicine/Public Health; Metastases; Metastasis; Methods; National libraries; Oncology; Patient outcomes; Patients; Staged hepatectomy; Surgical Oncology; Systematic literature review; Systematic Review; Systematic therapy; Treatment Outcome; Two-stage hepatectomy; Germany; Staged hepatectomy; Interval chemotherapy; Systematic therapy; Colorectal liver metastases; Two-stage hepatectomy; Systematic literature review
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-024-13008-9

Background Multimodal two-stage hepatectomy (mTSH) is used in patients with bilobar colorectal liver metastases (CRLM) that cannot be treated with one surgical procedure due to insufficient future liver remnant. Interval chemotherapy has been proposed to improve disease control in CRLM patients undergoing mTSH. We here present a narrative review of clinical studies on mTSH including the use of interval chemotherapy in patients with CRLM. Methods A systematic literature search of the PubMed databases as well as the ClinicalTrials.gov registry was performed. Results The use of interval chemotherapy during mTSH was reported in 23 studies and applied in 595 out of 1,461 patients with CRLM. Two studies report on the actual effects of this treatment, one study describes a trend towards improved disease progression rate. No serious adverse events caused by interval chemotherapy were observed. There is currently no randomized clinical trial investigating the efficacy and safety of interval chemotherapy during mTSH. Conclusion The currently available data indicate that interval chemotherapy does neither impair liver hypertrophy during mTSH nor cause procedure-associated complications in patients with CRLM. Results from randomized clinical trials on the potential positive effect on disease control are not yet available.