Hepatic resection in metastatic disease from colorectal cancer offers the best chance in selected cases for long-term survival. Neoadjuvant chemotherapy (NACT) has been advocated in some cases initially deemed irresectable, with few reports of the efficacy of such a strategy and the influence of the response to chemotherapy on the outcome of radical hepatic resection. Methodology: Between December 1995 and May 2005, 27 patients with colorectal liver metastases, (7 males, 20 females, mean age: 58¡À 8 years; range: 40-75) were treated with neoadjuvant chemotherapy. A 7 year survival analysis was performed. Chemotherapy included mainly 5-fluorouracil, leucovorin and either oxaliplatin or irinotecan for a median of 8 courses.

Sixteen patients (59%) had synchronous and 11 (41%) metachronous metastases. During pre-operative chemotherapy tumour regression occurred in 10 cases (37%); stable disease (SD) in a further 10 patients (37%) and progressive disease (PD) developed in 7 cases (26%). The 5 year overall survival for NACT responders was 64% and only 15% for non-responders (p=0.044).

The response to chemotherapy is likely to be a significant prognostic factor affecting survival after liver resection for cure.

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