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A systematic review and meta-analysis to reappraise the role of adjuvant hepatic arterial infusion for colorectal cancer liver metastases

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objective

The potential benefit of adjuvant hepatic arterial infusion remains unknown for patients with colorectal liver metastases after radical hepatic resection. The principle aim of this study was to investigate the long-term outcome of adjuvant hepatic arterial infusion.

Methods

Eligible trials were identified from Embase, PubMed, the Web of Science, and the Cochrane library since their inception to June 1, 2014. Patients with colorectal liver metastases, who underwent radical hepatic resection and received adjuvant hepatic arterial infusion, were enrolled. The study outcomes included 5-year disease-free and overall survival rate, respectively. Hazard ratio with a 95 % confidence interval was used to measure the pooled effect according to a random effects model or fixed effects model, depending on the heterogeneity between the included studies. The statistical heterogeneity between trials was detected by I 2 test. Sensitivity analyses were also carried out.

Results

A total of nine studies containing 1057 patients were included. The comparison indicated that the overall pooled hazard ratio for 5-year overall survival was 0.75 (95 % CI: 0.56–0.99, p = 0.048). The hazard ratio for 5-year disease-free survival rate was 0.61 (95 % CI: 0.48–0.79, p = 0.001). When compared with systemic chemotherapy alone, adjuvant hepatic arterial infusion plus systemic chemotherapy also improved the long-term survival.

Conclusions

Adjuvant hepatic arterial infusion improved the 5-year disease-free and overall survival rate, respectively. It should be recommended for patients with a high risk of recurrence, but these findings require prospective confirmation.

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Conflict of interest

The authors declare that they have no competing interests.

Funding

This study was not supported by any funding.

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Author notes

    Authors and Affiliations

    1. Hepatopancreatobiliary Surgery Department I, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing Cancer Hospital and Institute, Peking University School of Oncology, No. 52, Fu-Cheng-Lu Street, Beijing, 100142, People’s Republic of China

      Wei Liu & Bao-Cai Xing

    2. Beijing Key Laboratory of Cancer Therapeutic Vaccine, Beijing Shijitan Hospital, Capital Medical University Cancer Center, Beijing, China

      Qing-Kun Song

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    1. Wei Liu
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    2. Qing-Kun Song
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    3. Bao-Cai Xing
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    Corresponding author

    Correspondence to Bao-Cai Xing.

    Additional information

    Wei Liu and Qing-Kun Song contributed equally to this work.

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    Liu, W., Song, QK. & Xing, BC. A systematic review and meta-analysis to reappraise the role of adjuvant hepatic arterial infusion for colorectal cancer liver metastases. Int J Colorectal Dis 30, 1091–1102 (2015). https://doi.org/10.1007/s00384-015-2246-2

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    • DOI: https://doi.org/10.1007/s00384-015-2246-2

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