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Approximately 30% of patients will achieve a complete response and might not benefit from proceeding to resection.
Reasons for not proceeding to resection included progressive disease during preoperative chemotherapy (n=2), inoperable at laparotomy due to peritoneal/liver metastases undetected by preoperative imaging (n=4) and tumour considered too bulky on preoperative imaging (n=1).
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Of the 48 patients (80%) who proceeded to resection, only three were CRM+ve following resection.
Should the columella be excessively long and the nostrils be too large, we can proceed to resection a portion of the crus medialis and/or the alar wings to provide stability to the tip.
For those patients proceeding to liver resection, the median number of preoperative cycles of CAPOX plus bevacizumab was four.
In all, 86% of patients proceeded to surgical resection and R0 resection was achieved in 79% enrolled patients.
All six of these patients proceeded to surgical resection.
This patient did not proceed to surgical resection and was excluded from the final radiological analysis.
After chemotherapy, 3 patients had progressive disease and 12 patients were able to proceed to surgical resection.
The clinical resolution was absent in two patients, who proceeded to colonic resection (one patient) and radiologic abscess drainage (one patient).
In CRC, the use of NLR has previously been confirmed as an independent prognostic factor in a cohort of patients with liver-only colorectal metastases, the majority of whom proceeded to hepatic resection post chemotherapy (Kishi et al, 2009).
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