FOLFOX Enables High Resectability and Excellent Prognosis for Initially Unresectable Colorectal Liver Metastases

Background/Aim: To evaluate the efficacy of oxaliplatin plus fluorouracil and leucovorin (FOLFOX) on initially unresectable colorectal liver metastases (CRLM). Patients and Methods: From May 2005 to December 2008, FOLFOX was administered to 71 patients with initially unresectable CRLM. Hepatic resection was performed promptly after CRLM became resectable. Results: Twenty-six patients (37%) were downstaged as being resectable. The mean interval between the first FOLFOX and hepatic resection was six months (range, 3-7 months), and 7.1 courses (range, 2-12). Operative morbidity was 12% and mortality was nil. The median progression-free survival time was 19 and 7 months, and the median survival time was over 48 and 20 months, in finally resectable and unresectable patients, respectively. Multivariate analysis revealed that additional hepatic resection was the only independent prognostic factor (hazard ratio 4.80, p < 0.01). Conclusion: FOLFOX is an effective chemotherapeutic regimen leading to successful hepatic resection and an excellent prognosis for patients with initially CRLM.