Predictive Factors for the Benefit of Perioperative FOLFOX for Resectable Liver Metastasis in Colorectal Cancer Patients (EORTC Intergroup Trial 40983)
Identifieur interne : 004A99 ( PascalFrancis/Curation ); précédent : 004A98; suivant : 004B00Predictive Factors for the Benefit of Perioperative FOLFOX for Resectable Liver Metastasis in Colorectal Cancer Patients (EORTC Intergroup Trial 40983)
Auteurs : Halfdan Sorbye [Norvège] ; Murielle Mauer [Belgique] ; Thomas Gruenberger [Autriche] ; Bengt Glimelius [Suède] ; Graeme J. Poston [Royaume-Uni] ; Peter M. Schlag [Allemagne] ; Philippe Rougier [France] ; Wolf O. Bechstein [Allemagne] ; John N. Primrose [Royaume-Uni] ; Euan T. Walpole [Australie] ; Meg Finch-Jones [Royaume-Uni] ; Daniel Jaeck [France] ; Darius Mirza [Royaume-Uni] ; Rowan W. Parks [Royaume-Uni] ; Laurence Collette [Belgique] ; Eric Van Cutsem [Belgique] ; Werner Scheithauer ; Manfred P. Lutz [Allemagne] ; Bernard Nordlinger [France]Source :
- Annals of surgery [ 0003-4932 ] ; 2012.
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Abstract
Objective: In EORTC study 40983, perioperative FOLFOX increased progression-free survival (PFS) compared with surgery alone for patients with initially 1 to 4 resectable liver metastases from colorectal cancer (CRC). We conducted an exploratory retrospective analysis to identify baseline factors possibly predictive for a benefit of perioperative FOLFOX on PFS. Methods: The analysis was based on 237 events from 342 eligible patients. Cox proportional hazards regression models with a significance level of 0.1 were used to build up univariate and multivariate models. Results: After adjustment for identified prognostic factors, moderately (5.1- 30 ng/mL) and highly (> 30 ng/mL) elevated carcinoembryonic antigen (CEA) serum levels were both predictive for the benefit of perioperative chemotherapy (interaction P = 0.07; hazard ratio [HR] = 0.58 and HR = 0.52 for treatment benefit). For patients with moderately or highly elevated CEA (>5 ng/mL), the 3-year PFS was 35% with perioperative chemotherapy compared to 20% with surgery alone. Performance status (PS) 0 and BMI lower than 30 were also predictive for the benefit of perioperative chemotherapy (interaction P = 0.04 and P = 0.02). However, the number of patients with PS1 and BMI 30 or higher were limited. The benefit of perioperative therapy was not influenced by the number of metastatic lesions (1 vs 2-4, interaction HR = 0.98). Conclusions: Perioperative FOLFOX seems to benefit in particular patients with resectable liver metastases from CRC when CEA is elevated and when PS is unaffected, regardless of the number of metastatic lesions.
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Werner Scheithauer<affiliation><inist:fA14 i1="17"><s1>Department of Internal Medicine I & Comprehensive Cancer Center</s1><s3>INC</s3><sZ>17 aut.</sZ></inist:fA14><wicri:noCountry>INC</wicri:noCountry></affiliation>Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Predictive Factors for the Benefit of Perioperative FOLFOX for Resectable Liver Metastasis in Colorectal Cancer Patients (EORTC Intergroup Trial 40983)</title><author><name sortKey="Sorbye, Halfdan" sort="Sorbye, Halfdan" uniqKey="Sorbye H" first="Halfdan" last="Sorbye">Halfdan Sorbye</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Haukeland University Hospital</s1><s2>Bergen</s2><s3>NOR</s3><sZ>1 aut.</sZ></inist:fA14><country>Norvège</country></affiliation></author><author><name sortKey="Mauer, Murielle" sort="Mauer, Murielle" uniqKey="Mauer M" first="Murielle" last="Mauer">Murielle Mauer</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>EORTC Headquarters, Statistics Department</s1><s2>Brussels</s2><s3>BEL</s3><sZ>2 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Gruenberger, Thomas" sort="Gruenberger, Thomas" uniqKey="Gruenberger T" first="Thomas" last="Gruenberger">Thomas Gruenberger</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Medical University Vienna, Department of Internal Medicine I and Cancer Center and Department of General Surgery</s1><s2>Vienna</s2><s3>AUT</s3><sZ>3 aut.</sZ></inist:fA14><country>Autriche</country></affiliation></author><author><name sortKey="Glimelius, Bengt" sort="Glimelius, Bengt" uniqKey="Glimelius B" first="Bengt" last="Glimelius">Bengt Glimelius</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Radiology, Oncology and Radiation Science, Uppsala University</s1><s2>Uppsala</s2><s3>SWE</s3><sZ>4 aut.</sZ></inist:fA14><country>Suède</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Oncology and Pathology, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>4 aut.</sZ></inist:fA14><country>Suède</country></affiliation></author><author><name sortKey="Poston, Graeme J" sort="Poston, Graeme J" uniqKey="Poston G" first="Graeme J." last="Poston">Graeme J. Poston</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University Hospital Aintree</s1><s2>Liverpool</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Schlag, Peter M" sort="Schlag, Peter M" uniqKey="Schlag P" first="Peter M." last="Schlag">Peter M. Schlag</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Robert-Roessle-Klinik, Humboldt-Universitat Berlin, Surgery Department</s1><s2>Berlin</s2><s3>DEU</s3><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country></affiliation></author><author><name sortKey="Rougier, Philippe" sort="Rougier, Philippe" uniqKey="Rougier P" first="Philippe" last="Rougier">Philippe Rougier</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hôpitaux de Paris, Departments of Surgery and Oncology</s1><s2>Boulogne-Billancourt</s2><s3>FRA</s3><sZ>7 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Bechstein, Wolf O" sort="Bechstein, Wolf O" uniqKey="Bechstein W" first="Wolf O." last="Bechstein">Wolf O. Bechstein</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Klinikum der Johann-Wolfgang-Goethe-Universität, Department of General and Vascular Surgery</s1><s2>Frankfurt am Main</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country></affiliation></author><author><name sortKey="Primrose, John N" sort="Primrose, John N" uniqKey="Primrose J" first="John N." last="Primrose">John N. Primrose</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University Department of Surgery, Southampton General Hospital</s1><s2>Southampton</s2><s3>GBR</s3><sZ>9 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Walpole, Euan T" sort="Walpole, Euan T" uniqKey="Walpole E" first="Euan T." last="Walpole">Euan T. Walpole</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Princess Alexandra Hospital-University of Queensland, Woolloongabba, Brisbane</s1><s3>AUS</s3><sZ>10 aut.</sZ></inist:fA14><country>Australie</country></affiliation></author><author><name sortKey="Finch Jones, Meg" sort="Finch Jones, Meg" uniqKey="Finch Jones M" first="Meg" last="Finch-Jones">Meg Finch-Jones</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Bristol Royal Infirmary</s1><s2>Bristol</s2><s3>GBR</s3><sZ>11 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Jaeck, Daniel" sort="Jaeck, Daniel" uniqKey="Jaeck D" first="Daniel" last="Jaeck">Daniel Jaeck</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Hopital Universitaire Hautepierre</s1><s2>Strasbourg</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Mirza, Darius" sort="Mirza, Darius" uniqKey="Mirza D" first="Darius" last="Mirza">Darius Mirza</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>University Hospital Birmingham</s1><s2>Birmingham</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Parks, Rowan W" sort="Parks, Rowan W" uniqKey="Parks R" first="Rowan W." last="Parks">Rowan W. Parks</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>The Royal Infirmary of Edinburgh</s1><s2>Edinburgh</s2><s3>GBR</s3><sZ>14 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Collette, Laurence" sort="Collette, Laurence" uniqKey="Collette L" first="Laurence" last="Collette">Laurence Collette</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>EORTC Headquarters, Statistics Department</s1><s2>Brussels</s2><s3>BEL</s3><sZ>2 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Van Cutsem, Eric" sort="Van Cutsem, Eric" uniqKey="Van Cutsem E" first="Eric" last="Van Cutsem">Eric Van Cutsem</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>University Hospital Gasthuisberg, Digestive Oncology Unit</s1><s2>Leuven</s2><s3>BEL</s3><sZ>16 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Scheithauer, Werner" sort="Scheithauer, Werner" uniqKey="Scheithauer W" first="Werner" last="Scheithauer">Werner Scheithauer</name><affiliation><inist:fA14 i1="17"><s1>Department of Internal Medicine I & Comprehensive Cancer Center</s1><s3>INC</s3><sZ>17 aut.</sZ></inist:fA14><wicri:noCountry>INC</wicri:noCountry></affiliation></author><author><name sortKey="Lutz, Manfred P" sort="Lutz, Manfred P" uniqKey="Lutz M" first="Manfred P." last="Lutz">Manfred P. Lutz</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Caritasklinik St Theresa, Medical Department</s1><s2>Saarbrucken</s2><s3>DEU</s3><sZ>18 aut.</sZ></inist:fA14><country>Allemagne</country></affiliation></author><author><name sortKey="Nordlinger, Bernard" sort="Nordlinger, Bernard" uniqKey="Nordlinger B" first="Bernard" last="Nordlinger">Bernard Nordlinger</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hôpitaux de Paris, Departments of Surgery and Oncology</s1><s2>Boulogne-Billancourt</s2><s3>FRA</s3><sZ>7 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>France</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0199128</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 12-0199128 INIST</idno><idno type="RBID">Pascal:12-0199128</idno><idno type="wicri:Area/PascalFrancis/Corpus">001414</idno><idno type="wicri:Area/PascalFrancis/Curation">004A99</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Predictive Factors for the Benefit of Perioperative FOLFOX for Resectable Liver Metastasis in Colorectal Cancer Patients (EORTC Intergroup Trial 40983)</title><author><name sortKey="Sorbye, Halfdan" sort="Sorbye, Halfdan" uniqKey="Sorbye H" first="Halfdan" last="Sorbye">Halfdan Sorbye</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Haukeland University Hospital</s1><s2>Bergen</s2><s3>NOR</s3><sZ>1 aut.</sZ></inist:fA14><country>Norvège</country></affiliation></author><author><name sortKey="Mauer, Murielle" sort="Mauer, Murielle" uniqKey="Mauer M" first="Murielle" last="Mauer">Murielle Mauer</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>EORTC Headquarters, Statistics Department</s1><s2>Brussels</s2><s3>BEL</s3><sZ>2 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Gruenberger, Thomas" sort="Gruenberger, Thomas" uniqKey="Gruenberger T" first="Thomas" last="Gruenberger">Thomas Gruenberger</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Medical University Vienna, Department of Internal Medicine I and Cancer Center and Department of General Surgery</s1><s2>Vienna</s2><s3>AUT</s3><sZ>3 aut.</sZ></inist:fA14><country>Autriche</country></affiliation></author><author><name sortKey="Glimelius, Bengt" sort="Glimelius, Bengt" uniqKey="Glimelius B" first="Bengt" last="Glimelius">Bengt Glimelius</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Department of Radiology, Oncology and Radiation Science, Uppsala University</s1><s2>Uppsala</s2><s3>SWE</s3><sZ>4 aut.</sZ></inist:fA14><country>Suède</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Oncology and Pathology, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>4 aut.</sZ></inist:fA14><country>Suède</country></affiliation></author><author><name sortKey="Poston, Graeme J" sort="Poston, Graeme J" uniqKey="Poston G" first="Graeme J." last="Poston">Graeme J. Poston</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>University Hospital Aintree</s1><s2>Liverpool</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Schlag, Peter M" sort="Schlag, Peter M" uniqKey="Schlag P" first="Peter M." last="Schlag">Peter M. Schlag</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Robert-Roessle-Klinik, Humboldt-Universitat Berlin, Surgery Department</s1><s2>Berlin</s2><s3>DEU</s3><sZ>6 aut.</sZ></inist:fA14><country>Allemagne</country></affiliation></author><author><name sortKey="Rougier, Philippe" sort="Rougier, Philippe" uniqKey="Rougier P" first="Philippe" last="Rougier">Philippe Rougier</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hôpitaux de Paris, Departments of Surgery and Oncology</s1><s2>Boulogne-Billancourt</s2><s3>FRA</s3><sZ>7 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Bechstein, Wolf O" sort="Bechstein, Wolf O" uniqKey="Bechstein W" first="Wolf O." last="Bechstein">Wolf O. Bechstein</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Klinikum der Johann-Wolfgang-Goethe-Universität, Department of General and Vascular Surgery</s1><s2>Frankfurt am Main</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country></affiliation></author><author><name sortKey="Primrose, John N" sort="Primrose, John N" uniqKey="Primrose J" first="John N." last="Primrose">John N. Primrose</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University Department of Surgery, Southampton General Hospital</s1><s2>Southampton</s2><s3>GBR</s3><sZ>9 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Walpole, Euan T" sort="Walpole, Euan T" uniqKey="Walpole E" first="Euan T." last="Walpole">Euan T. Walpole</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Princess Alexandra Hospital-University of Queensland, Woolloongabba, Brisbane</s1><s3>AUS</s3><sZ>10 aut.</sZ></inist:fA14><country>Australie</country></affiliation></author><author><name sortKey="Finch Jones, Meg" sort="Finch Jones, Meg" uniqKey="Finch Jones M" first="Meg" last="Finch-Jones">Meg Finch-Jones</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Bristol Royal Infirmary</s1><s2>Bristol</s2><s3>GBR</s3><sZ>11 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Jaeck, Daniel" sort="Jaeck, Daniel" uniqKey="Jaeck D" first="Daniel" last="Jaeck">Daniel Jaeck</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Hopital Universitaire Hautepierre</s1><s2>Strasbourg</s2><s3>FRA</s3><sZ>12 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Mirza, Darius" sort="Mirza, Darius" uniqKey="Mirza D" first="Darius" last="Mirza">Darius Mirza</name><affiliation wicri:level="1"><inist:fA14 i1="14"><s1>University Hospital Birmingham</s1><s2>Birmingham</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Parks, Rowan W" sort="Parks, Rowan W" uniqKey="Parks R" first="Rowan W." last="Parks">Rowan W. Parks</name><affiliation wicri:level="1"><inist:fA14 i1="15"><s1>The Royal Infirmary of Edinburgh</s1><s2>Edinburgh</s2><s3>GBR</s3><sZ>14 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Collette, Laurence" sort="Collette, Laurence" uniqKey="Collette L" first="Laurence" last="Collette">Laurence Collette</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>EORTC Headquarters, Statistics Department</s1><s2>Brussels</s2><s3>BEL</s3><sZ>2 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Van Cutsem, Eric" sort="Van Cutsem, Eric" uniqKey="Van Cutsem E" first="Eric" last="Van Cutsem">Eric Van Cutsem</name><affiliation wicri:level="1"><inist:fA14 i1="16"><s1>University Hospital Gasthuisberg, Digestive Oncology Unit</s1><s2>Leuven</s2><s3>BEL</s3><sZ>16 aut.</sZ></inist:fA14><country>Belgique</country></affiliation></author><author><name sortKey="Scheithauer, Werner" sort="Scheithauer, Werner" uniqKey="Scheithauer W" first="Werner" last="Scheithauer">Werner Scheithauer</name><affiliation><inist:fA14 i1="17"><s1>Department of Internal Medicine I & Comprehensive Cancer Center</s1><s3>INC</s3><sZ>17 aut.</sZ></inist:fA14><wicri:noCountry>INC</wicri:noCountry></affiliation></author><author><name sortKey="Lutz, Manfred P" sort="Lutz, Manfred P" uniqKey="Lutz M" first="Manfred P." last="Lutz">Manfred P. Lutz</name><affiliation wicri:level="1"><inist:fA14 i1="18"><s1>Caritasklinik St Theresa, Medical Department</s1><s2>Saarbrucken</s2><s3>DEU</s3><sZ>18 aut.</sZ></inist:fA14><country>Allemagne</country></affiliation></author><author><name sortKey="Nordlinger, Bernard" sort="Nordlinger, Bernard" uniqKey="Nordlinger B" first="Bernard" last="Nordlinger">Bernard Nordlinger</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hôpitaux de Paris, Departments of Surgery and Oncology</s1><s2>Boulogne-Billancourt</s2><s3>FRA</s3><sZ>7 aut.</sZ><sZ>19 aut.</sZ></inist:fA14><country>France</country></affiliation></author></analytic><series><title level="j" type="main">Annals of surgery</title><title level="j" type="abbreviated">Ann. surg.</title><idno type="ISSN">0003-4932</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Annals of surgery</title><title level="j" type="abbreviated">Ann. surg.</title><idno type="ISSN">0003-4932</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Clinical trial</term><term>Colorectal cancer</term><term>Efficiency</term><term>European Organization for Research and Treatment of Cancer</term><term>Human</term><term>Liver cancer</term><term>Liver metastasis</term><term>Medicine</term><term>Patient</term><term>Perioperative</term><term>Predictive factor</term><term>Surgery</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cancer du foie</term><term>Facteur prédictif</term><term>Efficacité</term><term>Métastase foie</term><term>Périopératoire</term><term>Homme</term><term>Cancer colorectal</term><term>Malade</term><term>Essai clinique</term><term>Médecine</term><term>Chirurgie</term><term>Traitement</term><term>EORTC</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Médecine</term><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: In EORTC study 40983, perioperative FOLFOX increased progression-free survival (PFS) compared with surgery alone for patients with initially 1 to 4 resectable liver metastases from colorectal cancer (CRC). We conducted an exploratory retrospective analysis to identify baseline factors possibly predictive for a benefit of perioperative FOLFOX on PFS. Methods: The analysis was based on 237 events from 342 eligible patients. Cox proportional hazards regression models with a significance level of 0.1 were used to build up univariate and multivariate models. Results: After adjustment for identified prognostic factors, moderately (5.1- 30 ng/mL) and highly (> 30 ng/mL) elevated carcinoembryonic antigen (CEA) serum levels were both predictive for the benefit of perioperative chemotherapy (interaction P = 0.07; hazard ratio [HR] = 0.58 and HR = 0.52 for treatment benefit). For patients with moderately or highly elevated CEA (>5 ng/mL), the 3-year PFS was 35% with perioperative chemotherapy compared to 20% with surgery alone. Performance status (PS) 0 and BMI lower than 30 were also predictive for the benefit of perioperative chemotherapy (interaction P = 0.04 and P = 0.02). However, the number of patients with PS1 and BMI 30 or higher were limited. The benefit of perioperative therapy was not influenced by the number of metastatic lesions (1 vs 2-4, interaction HR = 0.98). Conclusions: Perioperative FOLFOX seems to benefit in particular patients with resectable liver metastases from CRC when CEA is elevated and when PS is unaffected, regardless of the number of metastatic lesions.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0003-4932</s0></fA01><fA02 i1="01"><s0>ANSUA5</s0></fA02><fA03 i2="1"><s0>Ann. surg.</s0></fA03><fA05><s2>255</s2></fA05><fA06><s2>3</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Predictive Factors for the Benefit of Perioperative FOLFOX for Resectable Liver Metastasis in Colorectal Cancer Patients (EORTC Intergroup Trial 40983)</s1></fA08><fA11 i1="01" i2="1"><s1>SORBYE (Halfdan)</s1></fA11><fA11 i1="02" i2="1"><s1>MAUER (Murielle)</s1></fA11><fA11 i1="03" i2="1"><s1>GRUENBERGER (Thomas)</s1></fA11><fA11 i1="04" i2="1"><s1>GLIMELIUS (Bengt)</s1></fA11><fA11 i1="05" i2="1"><s1>POSTON (Graeme J.)</s1></fA11><fA11 i1="06" i2="1"><s1>SCHLAG (Peter M.)</s1></fA11><fA11 i1="07" i2="1"><s1>ROUGIER (Philippe)</s1></fA11><fA11 i1="08" i2="1"><s1>BECHSTEIN (Wolf O.)</s1></fA11><fA11 i1="09" i2="1"><s1>PRIMROSE (John N.)</s1></fA11><fA11 i1="10" i2="1"><s1>WALPOLE (Euan T.)</s1></fA11><fA11 i1="11" i2="1"><s1>FINCH-JONES (Meg)</s1></fA11><fA11 i1="12" i2="1"><s1>JAECK (Daniel)</s1></fA11><fA11 i1="13" i2="1"><s1>MIRZA (Darius)</s1></fA11><fA11 i1="14" i2="1"><s1>PARKS (Rowan W.)</s1></fA11><fA11 i1="15" i2="1"><s1>COLLETTE (Laurence)</s1></fA11><fA11 i1="16" i2="1"><s1>VAN CUTSEM (Eric)</s1></fA11><fA11 i1="17" i2="1"><s1>SCHEITHAUER (Werner)</s1></fA11><fA11 i1="18" i2="1"><s1>LUTZ (Manfred P.)</s1></fA11><fA11 i1="19" i2="1"><s1>NORDLINGER (Bernard)</s1></fA11><fA14 i1="01"><s1>Haukeland University Hospital</s1><s2>Bergen</s2><s3>NOR</s3><sZ>1 aut.</sZ></fA14><fA14 i1="02"><s1>EORTC Headquarters, Statistics Department</s1><s2>Brussels</s2><s3>BEL</s3><sZ>2 aut.</sZ><sZ>15 aut.</sZ></fA14><fA14 i1="03"><s1>Medical University Vienna, Department of Internal Medicine I and Cancer Center and Department of General Surgery</s1><s2>Vienna</s2><s3>AUT</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Radiology, Oncology and Radiation Science, Uppsala University</s1><s2>Uppsala</s2><s3>SWE</s3><sZ>4 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Oncology and Pathology, Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>4 aut.</sZ></fA14><fA14 i1="06"><s1>University Hospital Aintree</s1><s2>Liverpool</s2><s3>GBR</s3><sZ>5 aut.</sZ></fA14><fA14 i1="07"><s1>Robert-Roessle-Klinik, Humboldt-Universitat Berlin, Surgery Department</s1><s2>Berlin</s2><s3>DEU</s3><sZ>6 aut.</sZ></fA14><fA14 i1="08"><s1>Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hôpitaux de Paris, Departments of Surgery and Oncology</s1><s2>Boulogne-Billancourt</s2><s3>FRA</s3><sZ>7 aut.</sZ><sZ>19 aut.</sZ></fA14><fA14 i1="09"><s1>Klinikum der Johann-Wolfgang-Goethe-Universität, Department of General and Vascular Surgery</s1><s2>Frankfurt am Main</s2><s3>DEU</s3><sZ>8 aut.</sZ></fA14><fA14 i1="10"><s1>University Department of Surgery, Southampton General Hospital</s1><s2>Southampton</s2><s3>GBR</s3><sZ>9 aut.</sZ></fA14><fA14 i1="11"><s1>Princess Alexandra Hospital-University of Queensland, Woolloongabba, Brisbane</s1><s3>AUS</s3><sZ>10 aut.</sZ></fA14><fA14 i1="12"><s1>Bristol Royal Infirmary</s1><s2>Bristol</s2><s3>GBR</s3><sZ>11 aut.</sZ></fA14><fA14 i1="13"><s1>Hopital Universitaire Hautepierre</s1><s2>Strasbourg</s2><s3>FRA</s3><sZ>12 aut.</sZ></fA14><fA14 i1="14"><s1>University Hospital Birmingham</s1><s2>Birmingham</s2><s3>GBR</s3><sZ>13 aut.</sZ></fA14><fA14 i1="15"><s1>The Royal Infirmary of Edinburgh</s1><s2>Edinburgh</s2><s3>GBR</s3><sZ>14 aut.</sZ></fA14><fA14 i1="16"><s1>University Hospital Gasthuisberg, Digestive Oncology Unit</s1><s2>Leuven</s2><s3>BEL</s3><sZ>16 aut.</sZ></fA14><fA14 i1="17"><s1>Department of Internal Medicine I & Comprehensive Cancer Center</s1><s3>INC</s3><sZ>17 aut.</sZ></fA14><fA14 i1="18"><s1>Caritasklinik St Theresa, Medical Department</s1><s2>Saarbrucken</s2><s3>DEU</s3><sZ>18 aut.</sZ></fA14><fA17 i1="01" i2="1"><s1>EORTC Gastro-Intestinal Tract Cancer Group, Cancer Research UK (CRUK), Arbeitsgruppe Lebermetastasen und-tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO)</s1><s3>INC</s3></fA17><fA20><s1>534-539</s1></fA20><fA21><s1>2012</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>2016</s2><s5>354000509828430210</s5></fA43><fA44><s0>0000</s0><s1>© 2012 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>29 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>12-0199128</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Annals of surgery</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Objective: In EORTC study 40983, perioperative FOLFOX increased progression-free survival (PFS) compared with surgery alone for patients with initially 1 to 4 resectable liver metastases from colorectal cancer (CRC). We conducted an exploratory retrospective analysis to identify baseline factors possibly predictive for a benefit of perioperative FOLFOX on PFS. Methods: The analysis was based on 237 events from 342 eligible patients. Cox proportional hazards regression models with a significance level of 0.1 were used to build up univariate and multivariate models. Results: After adjustment for identified prognostic factors, moderately (5.1- 30 ng/mL) and highly (> 30 ng/mL) elevated carcinoembryonic antigen (CEA) serum levels were both predictive for the benefit of perioperative chemotherapy (interaction P = 0.07; hazard ratio [HR] = 0.58 and HR = 0.52 for treatment benefit). For patients with moderately or highly elevated CEA (>5 ng/mL), the 3-year PFS was 35% with perioperative chemotherapy compared to 20% with surgery alone. Performance status (PS) 0 and BMI lower than 30 were also predictive for the benefit of perioperative chemotherapy (interaction P = 0.04 and P = 0.02). However, the number of patients with PS1 and BMI 30 or higher were limited. The benefit of perioperative therapy was not influenced by the number of metastatic lesions (1 vs 2-4, interaction HR = 0.98). Conclusions: Perioperative FOLFOX seems to benefit in particular patients with resectable liver metastases from CRC when CEA is elevated and when PS is unaffected, regardless of the number of metastatic lesions.</s0></fC01><fC02 i1="01" i2="X"><s0>002B01</s0></fC02><fC02 i1="02" i2="X"><s0>002B13C01</s0></fC02><fC02 i1="03" i2="X"><s0>002B13B01</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Cancer du foie</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Liver cancer</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Cáncer del hígado</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Facteur prédictif</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Predictive factor</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Factor predictivo</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Efficacité</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Efficiency</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Eficacia</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Métastase foie</s0><s2>NM</s2><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Liver metastasis</s0><s2>NM</s2><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Metástasis hígado</s0><s2>NM</s2><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Périopératoire</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Perioperative</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Perioperatorio</s0><s5>05</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Homme</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Human</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Hombre</s0><s5>06</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Cancer colorectal</s0><s2>NM</s2><s5>07</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Colorectal cancer</s0><s2>NM</s2><s5>07</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Cancer de colon y recto</s0><s2>NM</s2><s5>07</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Malade</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Patient</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Enfermo</s0><s5>08</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Essai clinique</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Clinical trial</s0><s5>09</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Ensayo clínico</s0><s5>09</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Médecine</s0><s5>11</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Medicine</s0><s5>11</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Medicina</s0><s5>11</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Chirurgie</s0><s5>12</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Surgery</s0><s5>12</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Cirugía</s0><s5>12</s5></fC03><fC03 i1="12" i2="X" l="FRE"><s0>Traitement</s0><s5>25</s5></fC03><fC03 i1="12" i2="X" l="ENG"><s0>Treatment</s0><s5>25</s5></fC03><fC03 i1="12" i2="X" l="SPA"><s0>Tratamiento</s0><s5>25</s5></fC03><fC03 i1="13" i2="X" l="FRE"><s0>EORTC</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="13" i2="X" l="ENG"><s0>European Organization for Research and Treatment of Cancer</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'appareil digestif</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Digestive diseases</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Aparato digestivo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie du foie</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Hepatic disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Hígado patología</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Tumeur maligne</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Malignant tumor</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Tumor maligno</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Cancer</s0><s2>NM</s2></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Cáncer</s0><s2>NM</s2></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du côlon</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Colonic disease</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Colón patología</s0><s5>40</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Pathologie de l'intestin</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Intestinal disease</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Intestino patología</s0><s5>41</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Pathologie du rectum</s0><s5>42</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Rectal disease</s0><s5>42</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Recto patología</s0><s5>42</s5></fC07><fN21><s1>156</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist></record>Pour manipuler ce document sous Unix (Dilib)
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