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Efficacy of various adjuvant chemotherapy methods in preventing liver metastasis from potentially curative colorectal cancer: A systematic review network meta-analysis of randomized clinical trials

Gastroenterologia
Imagem de arquivo, ilustrativa — não é do estudo. Células em divisão (mitose), em microscopia de fluorescência. ZEISS Microscopy · CC BY 2.0 · Wikimedia Commons

Revisão sistemáticaNível 1 · Evidência consolidadaCancer medicine22 ago 20226 citações

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Resumo original em inglês

O que aconteceu

Various chemotherapy administration methods have been used to prevent liver metastasis (LM) in patients with colorectal cancer (CRC). This network meta-analysis evaluated the efficacy of these different methods in preventing LM in CRC patients who underwent curative surgery.

A systematic search of randomized controlled trials reporting the efficacy of various adjuvant chemotherapy methods in patients with colorectal cancer who underwent curative surgery was conducted. The primary outcome was the LM rate.

O que encontraram

This network meta-analysis included 19 studies reporting on 12,588 participants, comparing portal vein infusion chemotherapy (PVIC) versus hepatic arterial infusion chemotherapy (HAIC) versus systematic chemotherapy (SC) versus surgery alone. The HAIC group had the lowest LM rate when compared to the other three groups (odds ratio [OR] of PVIC vs. HAIC: 1.86; OR of SC vs. HAIC: 1.98; and HAIC vs. surgery alone: 0.43). The LM rate did not differ significantly between PVIC, SC, and surgery alone. The recurrence rates were lower for PVIC and HAIC than for surgery alone (the ORs for PVIC and HAIC were 0.73 [95% CI: 0.58-0.92] and 0.45 [95% CI: 0.26-0.77]). The mortality rates of patients undergoing PVIC and HAIC were lower than that of patients undergoing surgery alone (the ORs for PVIC and HAIC were 0.77 [95% CI: 0.64-0.93] and 0.49 [95% CI: 0.24-0.98]). Anastomotic leakage, cardiopulmonary leakage, diarrhea, nausea and vomiting, oral ulceration, wound infection, or ileus did not differ significantly between the four groups. PVIC showed the highest hepatic toxicity rate compared to those for SC, HAIC, and surgery alone.

Por que isso importa

HAIC might be a satisfactory method for preventing LM in patients with CRC undergoing curative surgery.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.

O estudo original

Efficacy of various adjuvant chemotherapy methods in preventing liver metastasis from potentially curative colorectal cancer: A systematic review network meta-analysis of randomized clinical trials

Xianwei Liu, Qisheng Liu, Xiaoyu Wu, Wenbing Yu, Xinmin Bao

Descritores MeSH

  • Carcinoma, Hepatocellular
  • Liver Neoplasms
  • Colorectal Neoplasms
  • Humans
  • Infusions, Intra-Arterial
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Antineoplastic Combined Chemotherapy Protocols
  • Chemotherapy, Adjuvant
  • Fluorouracil

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