{"entity":{"id":"eortc-40983","kind":"trial","name":"EORTC 40983","aka":["EPOC"],"tldr":"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.","status":"mixed","asOf":"2026-09-24","links":[{"label":"ClinicalTrials.gov NCT00006479","url":"https://clinicaltrials.gov/study/NCT00006479"},{"label":"EORTC 40983: perioperative FOLFOX4 and surgery versus surgery alone for resectable liver metastases, long-term results (Lancet Oncology 2013)","url":"https://doi.org/10.1016/S1470-2045(13)70447-9"}],"tags":[],"related":[],"cancers":["colorectal"],"sections":[],"technologies":["cytotoxic-chemotherapy","platinum"],"targets":[],"drugs":["folfox","oxaliplatin","fluorouracil","leucovorin"],"companies":["curie-nki-eortc"],"institutions":[],"pathways":[],"terms":["hepatectomy","oligometastatic","neoadjuvant-adjuvant"],"trials":["new-epoc","cairo5"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"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","result":"No overall survival difference at 8.5 years (hazard ratio 0.88); the earlier progression-free survival benefit stands.","yearReported":2013,"enrolled":364,"enrolledBasis":"randomised","enrolledNote":"364 patients were randomised (182 per group); the registry entry carries no enrolment figure.","outcomes":[{"endpoint":"Overall survival","primary":true,"unit":"months","arms":[{"name":"Perioperative FOLFOX4 and surgery","n":182,"value":61.3},{"name":"Surgery alone","n":182,"value":54.3}],"hr":0.88,"ci":[0.68,1.14],"p":"0.34","source":"https://doi.org/10.1016/S1470-2045(13)70447-9"}]},"route":"/trials/eortc-40983/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"folfox","kind":"drug","name":"FOLFOX (5-FU, leucovorin, oxaliplatin)","route":"/drugs/folfox/"},{"id":"leucovorin","kind":"drug","name":"Leucovorin (folinic acid)","route":"/drugs/leucovorin/"},{"id":"oxaliplatin","kind":"drug","name":"Oxaliplatin","route":"/drugs/oxaliplatin/"}],"company":[{"id":"curie-nki-eortc","kind":"company","name":"EORTC","route":"/companies/curie-nki-eortc/"}],"term":[{"id":"hepatectomy","kind":"term","name":"Hepatectomy (liver resection)","route":"/terms/hepatectomy/"},{"id":"neoadjuvant-adjuvant","kind":"term","name":"Neoadjuvant / adjuvant / perioperative","route":"/terms/neoadjuvant-adjuvant/"},{"id":"oligometastatic","kind":"term","name":"Oligometastatic disease","route":"/terms/oligometastatic/"}],"trial":[{"id":"cairo5","kind":"trial","name":"CAIRO5","route":"/trials/cairo5/"},{"id":"new-epoc","kind":"trial","name":"New EPOC","route":"/trials/new-epoc/"}]}}