Perioperative chemotherapy for resectable colorectal hepatic metastases—What does the EORTC 40983 trial update mean?

The liver is the most common site of colorectal cancer metastasis. Although successful resectionleads to durable overall survival (OS), local and distant recurrence is common. As a result, multidisciplinarystrategies have been developed to decrease recurrence rates as well as increase the number of candidates forresection. A recent update to the European Organisation for Research and Treatment of Cancer (EORTC)Intergroup trial 40983 has been published comparing perioperative chemotherapy to surgery alone. Thisrandomized trial initially demonstrated a benefit in progression free survival (PFS) with the administrationof perioperative FOLFOX chemotherapy, albeit with an increased rate of complications. Although this ledmany investigators and clinicians to adopt the perioperative approach, the recent update failed to reportany advantage in OS and therefore results in further controversy as to the role of perioperative systemicchemotherapy in the treatment of resectable colorectal hepatic metastases.