Peri-operative chemotherapy for patients with resectable colorectal hepatic metastasis: A meta-analysis

AimsThe purpose of this meta-analysis is to assess the value of peri-operative chemotherapy for patients who have resectable colorectal cancer with liver metastases (CRCLM). The clinical effectiveness of peri-operative chemotherapy for CRCLM patients remains controversial.MethodsA literature review was performed to compare CRCLM patients receiving peri-operative chemotherapy plus surgery with patients receiving surgery alone. The Hazard ratio (HR), odds ratio (OR) and 95% confidence intervals (95% CIs) were set as effect measures.ResultsThere were 10 studies included in this meta-analysis, with a total of 1896 patients. There was no advantage in overall survival (OS) for patients receiving peri-operative chemotherapy compared with those who underwent surgery alone (HR, 0.88; 95% CI, [0.77, 1.01]; P = 0.07). However, there was significant benefit in disease-free survival (DFS) in patients who received chemotherapy compared with surgery alone (HR, 0.81; 95% CI, [0.72, 0.91]; P = 0.0007). In a subset analysis, the systemic chemotherapy group showed a DFS benefit (HR, 0.81; 95% CI, [0.69, 0.96]; P = 0.01) compared with different regional chemotherapy. The incidence of post-operative complications was significantly higher in patients who also received chemotherapy compared with the surgery alone group (OR, 1.42; 95% CI, [1.05, 1.92]; P = 0. 02).ConclusionsThere was no significant improvement in OS in CRCLM patients who received peri-operative chemotherapy compared with surgery alone, and chemotherapy significantly increased the post-operative complications. However, this requires further clinical study.