Peri-operative chemotherapy for the treatment of resectable liver metastases from colorectal cancer: A systematic review and meta-analysis of randomized trials.

Considering only the three trials of higher quality (HR, 0.82; 95% CI, 0.70-0.96) [ 11 , 15 , 20 ], the results did not differ significantly compared to all eight trials (HR, 0.77; 95% CI, 0.67-0.88) Despite a suboptimal regime which was standard at the time recruitment started, the two randomized trials investigating the effect of systemic adjuvant therapy with 5 FU/FA showed a trend towards a better RFS in one study (39 months vs. 20 months; HR, 0.78; 95% CI, 0.46-1.32; p = 0.35) [ 17 ], and a significant improvement in RFS in the other trial (24.4 months vs. 17.6 months; HR, 0.66; 95% CI, 0.46-0.96; p = 0.028) [ 20 ].

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The result for recurrence-free survival (RFS) was only of marginal significance and may have been due, in part, to the fact that both trials used an outdated chemotherapy regimen and had to be closed prematurely because of slow accrual [ 14 ].

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