• REsect is a retrospective analysis of the SIRFLOX study patient cohort.
• The extensive radiological database of SIRFLOX was evaluated by a panel of 14 HPB (Hepato-Pancreato-Biliary) surgeons from leading medical centres in Belgium, France, Germany, Italy, The Netherlands, Spain, the UK and the USA to compare potential liver resectability at baseline and follow-up.

Key Findings

The addition of a single session of SIR-Spheres Y-90 resin microspheres to FOLFOX (± bev)-based chemotherapy significantly increased by 9.2% the number of patients deemed technically resectable compared with chemo alone (38.1% in the SIRT + chemotherapy arm vs. 28.9% in the chemotherapy alone arm; p<0.0001).

Study Overview

• Analyses of baseline and follow-up scans from 472 patients.
• The reviewers were blinded to patient identifiers, visit (baseline or follow-up), treatment and clinical information, as well as to the other reviewers’ assessments.
• A patient was deemed resectable or unresectable by majority agreement (≥3 of 5 surgeons or ≥2 of 3 surgeons).

Patient characteristics

A total of 472 patients with similar baseline characteristics were evaluable (mFOLFOX n=228; mFOLFOX + SIRT n = 244).

Eligibility for Resection

REsect showed increased eligibility for liver resection following SIR-Spheres Y-90 resin microspheres.

• In patients with miliary disease* 3% in the control arm and 13% in the SIRT arm were considered to have resectable lesions at follow-up (p=0.029)
• Significantly more patients with an initial hepatic tumour burden ≤ 25% had technically resectable liver metastases at follow-up in the SIRT arm than those in the control arm (49.4% vs 34.7%, p=0.008)

*Miliary disease was defined as at least 15 metastases, with reason to assume the patient would remain unresectable after treatment

bev: bevacizumab (bevacizumab allowed at investigator’s discretion, per institutional practice)

Publication now online Garlipp B et al. Br J Surg 2019 Aug ePub: doi: 10.1002/bjs.11283.