A trial looking at chemotherapy before and after surgery for bowel cancer that has spread to the liver (EORTC 40983)

Cancer type:

Bowel (colorectal) cancer

Cancer spread to the liver

Secondary cancers

Status:

Results

Phase:

Phase 3

This trial was looking at chemotherapy before and after surgery to remove secondary liver cancer that had spread from a cancer that started in the bowel. In the UK, this trial was supported by Cancer Research UK.

If bowel cancer spreads, it often goes to the liver. Some people can have surgery to remove it, if the operation would leave them with enough healthy liver. This offers the best chance of keeping the cancer under control, but often the cancer comes back.

The aim of this trial was to find out if having chemotherapy both before and after surgery worked better than having surgery alone.

Summary of results

The trial team found that having chemotherapy and surgery was a useful treatment for bowel cancer that has spread.

The trial recruited 364 people. Half had FOLFOX chemotherapy before and after surgery. Half had surgery alone.

More people in the chemotherapy group had complications after surgery. And they had chemotherapy side effects such as diarrhoea, sore mouth and a drop in the number of white blood cells.

The researchers looked at how many people were living without any sign of their cancer having come back. Doctors call this progression free survival. They found that 3 years after treatment, cancer had come back in fewer people who had chemotherapy and surgery than in those who had surgery alone. The researchers worked out that for every 100 people who had chemotherapy as well as surgery, the cancer would come back in about 7 fewer people.

In 2013 the research team looked at how long people taking part in the trial lived for. Doctors call this overall survival. They found that the group who had chemotherapy as well as surgery lived a little longer, but the difference between the 2 groups could have happened by chance (the results were not statistically significant Open a glossary item ).

The trial team concluded that although the chemotherapy didn't help people live longer, it did help stop the cancer coming back after surgery. On balance they recommend that FOLFOX and surgery should be used as a treatment for this group of patients.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.