1. Resektable Lebermetastasen: Welche Modalität? ……………………………………………………………………………………………

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

3. Adjuvante Chemotherapie Stadium IV - 5-FU 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 Portier, J Clin Oncol 2006

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 45à30mm …...

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 patients182 +7.2% (28.1% to 35.4%)‏ 0.79 (0.62-1.02)‏ P=0.058 All eligible Patients 171 +8.1% (28.1% to 36.2%)‏ 0.77 (0.60-1.00)‏ P=0.041 All resected Patients 151152+9.2% (33.2% to 42.4%)‏ 0.73 (0.55-0.97)‏ P=0.025 EORTC 40983: PFS …………………………………………………………………………………..………