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Resektable Lebermetastasen: welche Modalität?. P=0,007 Parks, J Am Coll Surg 2007 Median OS: 47 vs 36 Monate Evidenzgrad IV Adjuvante Chemotherapie Stadium.

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Presentation on theme: "Resektable Lebermetastasen: welche Modalität?. P=0,007 Parks, J Am Coll Surg 2007 Median OS: 47 vs 36 Monate Evidenzgrad IV Adjuvante Chemotherapie Stadium."— Presentation transcript:

1 Resektable Lebermetastasen: welche Modalität?

2 P=0,007 Parks, J Am Coll Surg 2007 Median OS: 47 vs 36 Monate Evidenzgrad IV Adjuvante Chemotherapie Stadium IV - 5-FU Analyse von Kohortenstudien

3 Adjuvante Chemotherapie Stadium IV - 5-FU Portier, J Clin Oncol 2006 DFSOS n=173 (stopped prematurely, ITT: 171) Prim. EP: DFS (20% Unterschied im 2J. ÜL) Sek. EP: OS, safety 5 Yr DFS : 33.5 vs. 26.7% OR=0.66, p=0.028 Absolut. Benefit: 7% 5 Yr OS : 51.1 vs. 41.9% OR=0.73, p=0.13

4 Chemotherapie bei resektablen Metastasen

5 Perioperative Chemotherapie präOP: keine Therapie begonnen: 11 Pat. 6% alle 6 Zyklen absolviert: 78% Effektivität der Chemotherapie: CR 4%, PR 40% // PD // 6% Tumorverkleinerung: median 45  30mm

6 Perioperative Komplikationen Nordlinger et al., ASCO 2007

7 EORTC 40983: Resultate Eligible pts. Resected pts.

8 N pts CT N pts Surgery % absolute difference in 3-year PFS Hazard Ratio (Confidence Interval) P-value All patients % (28.1% to 35.4%) 0.79 ( ) P=0.058 All eligible Patients % (28.1% to 36.2%) 0.77 ( ) P=0.041 All resected Patients % (33.2% to 42.4%) 0.73 ( ) P=0.025 EORTC 40983: PFS


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