الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
BaHepatic resection of colorectal liver metastases is the cornerstone for providing better 5-year overall survival, however, the recurrence rate is still high. Therefore, there was increasing interest to use the chemotherapy combined with surgery to reduce the risk of recurrence. The benefit of neo-adjuvant chemotherapy in initially resectable CRLM is still debatable. Aim: evaluation of the role of NAC in the surgical outcome of resectable CRLM regarding DFS and OS. Patients and methods: This was retrospective study which included all patients underwent hepatectomy for initially resectable CRLM from January 2005 to December 2017 in France. The patient’s cohort was divided into 2 groups: NAC group (n=238) and upfront surgery group (n=64). Comparative analysis was done between 2 groups. Results: NAC group had significantly more synchronous CRLM (62.2% vs 34.4%), size (3 vs 2.3cm) and number (>2) (48.1% vs 3.2%), bilobar extention (49.2% vs 6.2%) and more EHM (23.8% vs 7.9%). There was no survival benefit of NAC regarding DFS (P=0.245) and OS (p=0.287). NAC was not significant predictor of DFS and OS. NAC was significant protector against early recurrence (p=0.012) in univariate analysis. In subgroup analysis, NAC had significantly longer DFS than upfront surgery in patients with synchronous CRLM, number of LM <2 and KRAS mutation (p=0.013). Conclusions: NAC had no survival benefit in patients with initially resectable CRLM regarding DFS and OS. NAC use was associated with decrease rate of early recurrence. We showed that NAC group had better in DFS in high risk patients with synchronous CRLM and KRAS mutation.