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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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Hepatectomy (liver resection), Oligometastatic disease, EORTC, Oxaliplatin.
Shares Leucovorin (folinic acid), Neoadjuvant / adjuvant / perioperative, Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin).
Shares Leucovorin (folinic acid), Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU).
Shares Leucovorin (folinic acid), Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU).
Shares Neoadjuvant / adjuvant / perioperative, Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin), Platinum agents.
Shares Leucovorin (folinic acid), Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU).
Shares CAIRO5, Oxaliplatin, Fluorouracil (5-FU), Platinum agents.
Shares Leucovorin (folinic acid), Oxaliplatin, FOLFOX (5-FU, leucovorin, oxaliplatin), Fluorouracil (5-FU).