COSA 2013* The Potential for Freedom from Adjuvant Chemotherapy: An Under-Recognized Benefit of Surgical Therapy for Colorectal Liver Metastases (#109)
Even with significant advances in the field, at most 20% of patients with colorectal liver metastases are candidates for ‘curative’ hepatic resection. For those who are candidates for surgical treatment, the most obvious and well-described benefits of this modality is a significant increase in survival time (median: ~50 months) compared to chemotherapy alone (median: ~24 months).
An additional but less-frequently discussed benefit of surgical therapy is the potential for freedom from systemic therapy. Colorectal liver metastases patients with preserved performance status who are not considered candidates for surgery are typically treated with continuous systemic therapy in some form until progression or dose-limiting toxicity. Although these therapies prolong life, they can be associated with significant costs (financial, psychological, and quality of life).
The subject of this presentation will be to compare and contrast the morbidities and costs associated with surgical vs. medical therapies for this disease, highlighting the potential secondary benefits of surgery when it leads to negative staging scans and a multidisciplinary decision to suspend systemic chemotherapy.
