Adjuvant chemotherapy for resected colorectal cancer metastases: literature revision and meta-analysis

Surgical resection is the only option of cure for patients with metastatic colorectal cancer (CRC). However, the risk of recurrence within 18 months after metastasectomy is around of 75% and the liver is the most frequent site of relapse. The current international guidelines recommend an adjuvant therapy for patients who underwent surgical resection of CRC metastases, despite the lower level of evidence (based on the quality of studies in this setting). Actually, up to now there is no standard treatment encoded and the effective role of an adjuvant therapy remains still controversial. The aim of this review is to report the state-of-art about the role of systemic chemotherapy with hepatic arterial infusion (HAI) in the management of patients after resection of metastases from CRC, with literature revision and a meta-analysis of the randomized-controlled trials.