Safety, tolerability, and efficacy of oxaliplatin-based adjuvant chemotherapy after curative resection of hepatic or extrahepatic metastases of Stage IV colorectal cancer.

Purpose: Surgery is the only potentially curative strategy for patients who have Stage IV colorectal cancer (CRC) with resectable metastases, but relapse is common. Randomized trials of adjuvant 5-FU-based systemic chemotherapy have not demonstrated any benefit after resection of liver metastases. We evaluated the efficacy, safety, and tolerability of oxaliplatin-based adjuvant chemotherapy after curative resection of hepatic or extrahepatic metastases of CRC.
Methods: We retrospectively studied data for 88 consecutive patients with Stage IV CRC who underwent curative resection of metastases followed by oxaliplatin-based adjuvant chemotherapy between March 2007 and June 2013.
Results: The 3-year relapse-free survival (RFS) rate was 54.0 %. There was no significant difference in 3-year RFS between patients with metastases confined to the liver (52.7 %) and patients with extrahepatic metastases (57.2 %). Multivariate analysis revealed that the site of the primary tumor (right-sided colon or left-sided colon/rectum) and the number of metastases (solitary or multiple) were predictors of RFS. Scheduled courses were completed in 80.7 % of the patients. Except for neutropenia (47.7 %), severe adverse events were observed in <5 % of patients.
Conclusions: Oxaliplatin-based adjuvant chemotherapy could be an effective option for selected patients with Stage IV CRC after curative resection of hepatic or extrahepatic metastases, and is both safe and tolerable.