Resektable Lebermetastasen: Welche Modalität? ……………………………………………………………………………………………

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Presentation transcript:

Resektable Lebermetastasen: Welche Modalität? ……………………………………………………………………………………………

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 …...

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

Chemotherapie bei resektablen Metastasen ………………………………………………………………………………………………….………………

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 …...

Perioperative Komplikationen ……………………………………………………………………………………………………………………………………… Nordlinger et al., ASCO 2007

EORTC 40983: Resultate Eligible pts. Resected pts. …………………………………………………………………………………..………

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 …………………………………………………………………………………..………