Gastrointestinal Tumors

Review

Network Meta-Analysis of Adjuvant Chemotherapy following Resection of Colorectal Liver Metastases

Gavriilidis P.a · Tobias A.b · Sutcliffe R.P.a · Azoulay D.c · Roberts K.J.a

Author affiliations

aDepartment of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Queen Elizabeth University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
bBiostatistician in the Spanish Council for Scientific Research (CSIC), Barcelona, Spain
cDepartment of Hepato-Pancreato-Biliary and Liver Transplantation, Henri Mondor University Hospital, Créteil, France

Keywords: Network meta-analysisResected colorectal liver metastasesAdjuvant chemotherapy

Related Articles for ""
Gastrointest Tumors 2018;5:21–31
https://doi.org/10.1159/000490763

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Article / Publication Details

First-Page Preview
Abstract of Review

Received: May 09, 2018
Accepted: June 05, 2018
Published online: July 25, 2018
Issue release date: September 2018

Number of Print Pages: 11
Number of Figures: 6
Number of Tables: 1

ISSN: 2296-3774 (Print)
eISSN: 2296-3766 (Online)

For additional information: https://www.karger.com/GAT

Abstract

Objective: Six principal adjuvant chemotherapy treatments (ACTs) are currently available for patients with resected colorectal liver metastases. This meta-analysis was designed to determine the optimal ACT, as evaluated by 2-year disease-free survival (DFS) and 5-year overall survival (OS) rates as well as by hepatic recurrences and adverse events (AEs). Methods: A systematic literature search of the PubMed, EMBASE, Medline, Cochrane Library, and Google Scholar databases was performed. The probability of the optimal therapeutic scheme and the mean ranking were estimated for each treatment using network meta-analysis. Results: Systemic chemotherapy (SCT) had the best 2-year DFS rate (hazard ratio [HR] = 0.78, 95% confidence interval [CI] = 0.48–1.27, 95% prediction interval [PI] = 0.17–3.56, surface under the cumulative ranking area [SUCRA] = 73) and the lowest AE rate (estimated SUCRA = 65 and predicted SUCRA = 62). Hepatic arterial infusion (HAI) plus SCT had the best 5-year OS rate (HR = 0.81, 95% CI = 0.64–1.01, 95% PI = 0.50–1.29) and the lowest hepatic recurrence rate (odds ratio = 2.87, 95% CI = 1.56–5.30, 95% PI = 0.61–13.62). Conclusion: Both SCT and HAI plus SCT showed superior efficacy and safety. Clinical trials in homogeneous populations with strict selection criteria are needed to compare these two ACTs.

© 2018 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Review

Received: May 09, 2018
Accepted: June 05, 2018
Published online: July 25, 2018
Issue release date: September 2018

Number of Print Pages: 11
Number of Figures: 6
Number of Tables: 1

ISSN: 2296-3774 (Print)
eISSN: 2296-3766 (Online)

For additional information: https://www.karger.com/GAT

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2018, Vol.5, No. 1-2

September 2018

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