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More patients received the operation in the surgery group than in the perioperative chemotherapy group table 4.

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Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. The improvement in progression-free survival with chemotherapy was recorded during the first 2 years but afterwards the curves seemed to remain parallel.

This article has been cited by other articles in PMC. Show off your favorite photos and videos to the world, securely and privately show content to your friends and family, or blog the photos and videos you take with a WeTransfer is the simplest way to send your files around the world. Table 3 shows the tolerance to postoperative chemotherapy.

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Our results have shown that perioperative chemotherapy was compatible with major liver surgery. A prognostic scoring system to improve case selection, based on patients.

Discussion We have shown that perioperative chemotherapy with FOLFOX4 reduced the risk of prorqil survival events at 3 years by a quarter in patients with resectable liver metastases. After preoperative chemotherapy mm 33 0 to The primary tumour had to be either already resected R0 resection or judged to be resectable in case of synchronous metastases by the multidisciplinary team at the treating hospital.


Figure 1 shows the reasons why postoperative protocol chemotherapy was not started in the remaining patients. Table 3 Adverse events during chemotherapy and postoperative complications. Statistical analysis Rates of progression-free survival were estimated by the Kaplan-Meier method 16 and compared by the logrank test. We recorded no deaths due to toxic effects.

prrail The present European Intergroup trial aimed to compare perioperative chemotherapy—ie, before and after surgery—with surgery alone in patients with one to four hepatic colorectal cancer metastases that are considered to be resectable on imaging. Recurrence was diagnosed by imaging, cytology, or histology.

For all patients randomly assigned and those who were eligible, no surgery or no resection were regarded as events for the primary endpoint of progression-free survival. N Engl J Med. Table 2 Compliance, treatment tolerance, and treatment response to perioperative chemotherapy. Adjustment of the primary analysis for the stratification factors risk pprorail and previous adjuvant chemotherapy did not change the results data not shown.

We believe that this moderate increase in the risks of liver surgery after chemotherapy does not compromise the potential benefits of the treatment. Nonparametric estimation from incomplete observations.

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Clinical and neurological examination and assessment of haematology, biochemistry, and toxic effects 12 were undertaken before each chemotherapy cycle, and up to 30 days after treatment.

Author information Copyright and License information Disclaimer. We conclude that perioperative FOLFOX4 chemotherapy reduced the risk of events of progression-free survival by a quarter and was compatible with major surgery.

Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer.

Statistical analysis of failure time data. We administered only six cycles preoperatively.

It improves the outcome of patients with stage III colon cancers 4 and therefore might also be effective in stage IV disease after surgery. Sanofi-Aventis provided free oxaliplatin and an educational grant. Patients were centrally randomised cai minimisation, adjusting for centre and risk score. National Cancer Institute Common toxicity criteria version 2. The principal reason for non-resectability was more advanced disease than was expected, which was probably mostly due to a discrepancy between imaging and surgical examination.

The number of patients who finally underwent resection was much the same in both treatment groups. Sensitivity analyses not protocol-specified but decided before data analysis were undertaken both in all eligible patients and all those prorxil resectable liver metastases.