Randomized Phase II/III Trial Comparing Hepatectomy, Followed by mFOLFOX6 With Hepatectomy Alone for Liver Metastasis From Colorectal Cancer: Long-Term Results of JCOG0603

The Journal of Clinical Oncology has published the long-term results of JCOG0603, a landmark Japanese randomized Phase II/III trial evaluating whether adding adjuvant mFOLFOX6 chemotherapy after liver resection improves outcomes for patients with colorectal cancer liver metastases compared to surgery alone. This trial addresses a longstanding clinical question, as the role of adjuvant chemotherapy following hepatectomy in this setting has remained controversial despite being widely practiced. The long-term data from JCOG0603 are particularly significant because earlier interim analyses suggested that adjuvant mFOLFOX6 did not confer an overall survival benefit and may have been associated with worse outcomes, challenging the prevailing assumption that post-operative chemotherapy is routinely beneficial. These mature results provide the highest-level evidence to date on this clinical question and are expected to influence treatment guidelines for the management of resectable colorectal liver metastases worldwide.