Medicine
Comparative efficacy of common adjuvant treatments after resection of colorectal liver metastases: A systematic review and network meta-analysis
By Zhou Y, Wang Q, Liu L and 5 others.
Abstract
Background
Although adjuvant strategies such as systemic chemotherapy, regional nonsystemic chemotherapy, and ablation have been applied, the optimal adjuvant therapeutic strategy for resectable colorectal liver metastases remains uncertain in terms of overall survival and disease-free survival. This network meta-analysis aimed to determine the optimal adjuvant therapeutic strategy for patients with colorectal liver metastases.
Methods
We searched potentially eligible studies in PubMed, Embase, Cochrane Central Register of Controlled Trials, and China National Knowledge Infrastructure databases until July 2026. Pooled disease-free survival (DFS) and overall survival (OS) were estimated using R software.
Results
Eighteen studies including 18 reports were included. For the DFS, except for adjuvant hepatic arterial infusion chemotherapy (CT, HAIC) concomitant with intravenous CT, adjuvant CT and perioperative CT significantly improved DFS compared with surgery and adjuvant HAIC. There was no statistical difference between all therapeutic strategies for OS. Adjuvant HAIC concomitant with intravenous CT had the highest probability of being the best treatment for improving DFS (85.01%), followed by perioperative CT (11.75%) and adjuvant CT (3.17%); however, adjuvant HAIC concomitant with intravenous CT had the highest probability of being the best adjuvant treatment for improving OS (52.46%), followed by perioperative CT (40.25%) and adjuvant HAIC (5.25%).