According to an article recently published in the Journal of Clinical Oncology, a complete disappearance of cancer as detected by computed tomography (CT) following chemotherapy for the treatment of colorectal cancer spread to the liver rarely results in a cure. Other treatment options, perhaps in addition to chemotherapy, may improve outcomes for these patients.
Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Stage IV, or metastatic, colorectal cancer refers to cancer that has spread from the colon or rectum to distant sites in the body. One common site to which colorectal cancer spreads is the liver, referred to as liver metastasis.
There are several therapeutic options for the treatment of liver metastasis. Researchers continue to evaluate and compare these methods in an effort to achieve optimal outcomes. The method of treatment is often determined by the size of the cancer, the number of metastases, and the location of the cancers within the liver.
Patients with liver metastases from colorectal cancer are often treated with chemotherapy. These patients then undergo scans, such as a CT scan, to help determine the effectiveness of treatment.
Researchers from France recently conducted a study to evaluate the effects of treatment with chemotherapy alone for patients with colorectal cancer with liver metastasis. This study included 586 patients with liver metastasis who had fewer than 10 sites of liver metastasis. Following chemotherapy, results from CT scans indicated a complete disappearance of one or several liver metastasis. Surgery was then performed within four weeks of the scans. Patients did not have cancer detectable outside the liver.
- Cancer cells were found during surgery in nearly one-third of the sites of liver metastasis that revealed a complete disappearance of cancer by CT scans.
- After one year, 23 of the 31 sites of liver metastasis that had demonstrated a complete disappearance through CT scans had recurred.
- Overall, 83% of all sites of liver metastasis that demonstrated a complete disappearance on CT scans had recurred or cancer cells had persisted as determined through surgery.
The researchers concluded that a complete disappearance of sites of liver metastasis following chemotherapy among patients with colorectal cancer as determined by CT scans still results in recurrences or persistent cancer cells in the majority of these sites. Perhaps other types of imaging as well as other therapy in addition to chemotherapy will improve outcomes for these patients.
Reference: Benoist S, Brouquet A, Penna C, et al. Complete Response of Colorectal Liver Metastases After Chemotherapy: Does It Mean Cure? Journal of Clinical Oncology. 2006; 24:3939-3945.
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