Liu JY, Liang ZH, Liu JL, Li L, Cui B, Li TG. Clinical observation of combined transarterial chemoembolization and targeted therapy in postoperative recurrent colorectal cancer with liver metastasis. World J Gastrointest Surg 2025; 17(8): 104568 [DOI: 10.4240/wjgs.v17.i8.104568]
Corresponding Author of This Article
Jian-Yu Liu, MD, Associate Chief Physician, Department of Interventional Treatment, Bethune International Peace Hospital of PLA, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang 050082, Hebei Province, China. ljiany109527@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2025; 17(8): 104568 Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.104568
Clinical observation of combined transarterial chemoembolization and targeted therapy in postoperative recurrent colorectal cancer with liver metastasis
Jian-Yu Liu, Zhi-Hui Liang, Jing-Lei Liu, Liang Li, Bao Cui, Tie-Gang Li
Jian-Yu Liu, Zhi-Hui Liang, Jing-Lei Liu, Liang Li, Bao Cui, Department of Interventional Treatment, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, Hebei Province, China
Tie-Gang Li, Department of Oncology, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, Hebei Province, China
Author contributions: Liu JY and Liang ZH were the guarantors and designed the study; Liu JY, Liang ZH, and Liu JL participated in the acquisition, analysis, and interpretation of the data and drafted the initial manuscript; Li L, Cui B, and Li TG revised the article critically for important intellectual content. All the authors participated in this study and jointly reviewed and edited the manuscript.
Supported by 2023 Hebei Provincial Medical Scientific Research Project Plan, No. 20231304.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Bethune International Peace Hospital of PLA, No. BIPH-LL-2022-003.
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: There is no available data.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Yu Liu, MD, Associate Chief Physician, Department of Interventional Treatment, Bethune International Peace Hospital of PLA, No. 398 Zhongshan West Road, Qiaoxi District, Shijiazhuang 050082, Hebei Province, China. ljiany109527@163.com
Received: March 26, 2025 Revised: April 21, 2025 Accepted: June 30, 2025 Published online: August 27, 2025 Processing time: 152 Days and 4.8 Hours
Abstract
BACKGROUND
Colorectal cancer (CRC) with liver metastasis remains a significant therapeutic challenge, particularly in cases of postoperative recurrence. While transarterial chemoembolization (TACE) and targeted therapies have shown promise individually, the efficacy combining these for treating postoperative recurrent CRC with liver metastasis requires further investigation.
AIM
To evaluate the efficacy and safety of TACE combined with targeted therapies for postoperative recurrent CRC with liver metastasis.
METHODS
This observational study enrolled 75 patients with postoperative recurrent CRC accompanied by liver metastasis between January 2020 and December 2023. All patients received combined treatment with TACE and targeted therapy: Bevacizumab (40 patients, 53.3%), cetuximab (25 patients, 33.3%), or panitumumab (10 patients, 13.3%). Treatment response was evaluated using the Response Evaluation Criteria in Solid Tumors 1.1 criteria, with overall survival (OS) and progression-free survival as the primary endpoints. Quality of life was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire at baseline and after six months of treatment.
RESULTS
The median OS was 28 months (95% confidence interval: 24-32 months), and the median progression-free survival was 12 months (95% confidence interval: 10-14 months). Patients treated with bevacizumab showed significantly better survival outcomes than those treated with cetuximab/panitumumab (median OS, 30 vs 24 months, P = 0.015). The overall response rate was 58.7%, with a disease control rate of 86.7%. Quality of life scores improved significantly across all domains, with greater improvements observed in the bevacizumab group. Treatment-related adverse events were manageable, with grade 3-4 events occurring in 13.3% of the patients and no treatment-related mortality.
CONCLUSION
The combination of TACE with targeted therapy, particularly bevacizumab, has demonstrated promising efficacy and acceptable safety for the treatment of postoperative recurrent CRC with liver metastasis. This multimodal approach not only improved survival outcomes but also enhanced the patients’ quality of life, suggesting its potential as a valuable treatment strategy for this challenging condition.
Core Tip: This study investigates the combination of transarterial chemoembolization and targeted therapies (bevacizumab, cetuximab, and panitumumab) for the treatment of postoperative recurrent colorectal cancer with liver metastasis. The results indicate that this multimodal approach improved overall survival (28 months) and progression-free survival (12 months), with bevacizumab showing superior outcomes. The treatment is well tolerated, with manageable adverse events, and significantly enhances the patients’ quality of life. This combination therapy has the potential to be an effective and safe strategy for this challenging clinical scenario.
