Evidence map›Paper›PMID 40696253›Full record

ArticleAnnals of surgical oncology2025

Reduced Floxuridine Dose Limits Hepatobiliary Toxicity Without Negatively Impacting Survival After Resection of Colorectal Cancer Liver Metastases.

Kevin P Labadie, Darrell Fan, Dana A Dominguez, Paul Wong, Elizabeth Meshkin, Peter Vien, S Cecilia Lau, Jonathan Kessler, Lawrence D Wagman, Yuman Fong and 2 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kevin P LabadieDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Darrell FanDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Dana A DominguezDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Paul WongDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Elizabeth MeshkinDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Peter VienDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
S Cecilia LauDepartment of Pharmacy Services, City of Hope National Medical Center, Duarte, CA, USA.
Jonathan KesslerDivision of Interventional Radiology, Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, USA.
Lawrence D WagmanDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Yuman FongDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA.
Marwan G FakihDepartment of Medical Oncology & Therapeutics Research, City of Hope National Medical Center, Duarte, CA, USA.
Laleh G MelstromDivision of Surgical Oncology, Department of Surgery, City of Hope National Medical Center, Duarte, CA, USA. lmelstrom@coh.org.ORCID http://orcid.org/0000-0001-6279-7981

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHepatic arterial infusion (HAI) of floxuridine is an effective adjuvant therapy for colorectal liver metastases (CRLM) following complete resection, but its use is limited by hepatobiliary toxicity. Dosing characteristics, factors associated with dose reductions, and the impact of starting dose on hepatobiliary toxicity and survival in the adjuvant setting are poorly described.

methodsFrom 2015 to 2024, patients who received adjuvant HAI floxuridine after complete CRLM resection at City of Hope were included. Hepatobiliary toxicity and oncologic outcomes of standard (0.12 mg/kg/day) versus reduced (0.08 mg/kg/day) dosing were compared. Extent of hepatobiliary toxicity, factors associated with dose reductions, hepatic recurrence-free survival (H-RFS), and overall survival (OS) were examined.

resultsSeventy-one patients were included (median age 52). Dosing information was available for 69 patients with 40 (58%) receiving the standard dose and 29 (42%) receiving the reduced dose. Patients receiving the standard dose had significantly higher rates of hepatobiliary toxicity, including increased transaminases, alkaline phosphatase, and bilirubin levels. Biliary sclerosis requiring endoscopic intervention occurred only in the standard-dose group (n = 4, 10%). Dose reductions were more frequent in the standard-dose group (82% vs. 53%, p = 0.04). Despite lower cumulative floxuridine exposure, the reduced dose did not compromise oncologic outcomes.

conclusionsA reduced starting floxuridine dose (0.08 mg/kg/day) is associated with lower hepatobiliary toxicity without compromising survival after complete resection of CRLM. These findings support adopting the reduced dose as a new standard in the adjuvant treatment of resected CRLM.

Indexed as

Antimetabolites, AntineoplasticColorectal NeoplasmsFloxuridineHepatectomyLiver NeoplasmsAdultAgedChemotherapy, AdjuvantFemaleFollow-Up StudiesHumansInfusions, Intra-ArterialMaleMiddle AgedPrognosisRetrospective StudiesAntimetabolites, AntineoplasticFloxuridine

Identifiers

PMID40696253
PMCPMC12589368

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.