# EORTC 40983

Source: https://onco.cc/trials/eortc-40983/  
OnCo record `eortc-40983` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Chemotherapy around liver surgery delayed recurrence but, after eight years, did not extend life. It is still given, on the strength of the earlier endpoint.

## Summary

EORTC 40983 randomised 364 patients with up to four resectable colorectal liver metastases to perioperative FOLFOX4 (six cycles before and six after surgery) or surgery alone. The earlier report showed better progression-free survival. At a median 8.5 years, 107 of 182 patients in the chemotherapy group had died against 114 of 182 with surgery alone (hazard ratio 0.88, 95% CI 0.68 to 1.14, p=0.34); median overall survival was 61.3 against 54.3 months and five-year survival 51.2 against 47.8 percent. The authors kept perioperative FOLFOX4 as the reference treatment because of the progression-free survival gain, but the trial is the honest measure of how much chemotherapy adds to a well-done liver resection: not demonstrably any life.

## Fields

- Kind: Trial
- Status: mixed
- Last checked: 2026-09-24
- Also known as: EPOC
- Registry id: NCT00006479
- Phase: 3
- Setting: Up to four resectable colorectal liver metastases: six cycles of FOLFOX4 before and six after liver resection, against surgery alone
- Sponsor: European Organisation for Research and Treatment of Cancer
- Enrolled: 364
- Result: No overall survival difference at 8.5 years (hazard ratio 0.88); the earlier progression-free survival benefit stands.
- Outcomes: Overall survival: Perioperative FOLFOX4 and surgery 61.3 months vs Surgery alone 54.3 months, HR 0.88

## Sources

- ClinicalTrials.gov NCT00006479: https://clinicaltrials.gov/study/NCT00006479
- EORTC 40983: perioperative FOLFOX4 and surgery versus surgery alone for resectable liver metastases, long-term results (Lancet Oncology 2013): https://doi.org/10.1016/S1470-2045(13)70447-9

## Connected records

- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Platinum agents](https://onco.cc/technologies/platinum/)
- drugs: [Fluorouracil (5-FU)](https://onco.cc/drugs/fluorouracil/), [FOLFOX (5-FU, leucovorin, oxaliplatin)](https://onco.cc/drugs/folfox/), [Leucovorin (folinic acid)](https://onco.cc/drugs/leucovorin/), [Oxaliplatin](https://onco.cc/drugs/oxaliplatin/)
- companies: [EORTC](https://onco.cc/companies/curie-nki-eortc/)
- terms: [Hepatectomy (liver resection)](https://onco.cc/terms/hepatectomy/), [Neoadjuvant / adjuvant / perioperative](https://onco.cc/terms/neoadjuvant-adjuvant/), [Oligometastatic disease](https://onco.cc/terms/oligometastatic/)
- trials: [CAIRO5](https://onco.cc/trials/cairo5/), [New EPOC](https://onco.cc/trials/new-epoc/)

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