LESSONS LEARNED: Three-month adjuvant capecitabine plus oxaliplatin in 
combination (CAPOX) appeared to reduce recurrence, with mild toxicity in 
postcurative resection of colorectal cancer liver metastases (CLM). Recurrence 
in patients who underwent the 3-month adjuvant CAPOX after resection of CLM was 
most commonly at extrahepatic sites.
BACKGROUND: The role of neoadjuvant and adjuvant chemotherapy in the management 
of initially resectable colorectal cancer liver metastases (CLM) is still 
unclear. We evaluated the feasibility of 3-month adjuvant treatment with 
capecitabine plus oxaliplatin in combination (CAPOX) for postcurative resection 
of CLM.
METHODS: Patients received one cycle of capecitabine followed by four cycles of 
CAPOX as adjuvant chemotherapy after curative resection of CLM. Oral 
capecitabine was given as 1,000 mg/m2 twice daily for 2 weeks in a 3-week cycle, 
and CAPOX consisted of oral capecitabine plus oxaliplatin 130 mg/m2 on day 1 in 
a 3-week cycle. Primary endpoint was the completion rate of adjuvant 
chemotherapy. Secondary endpoints included recurrence-free survival (RFS), 
overall survival (OS), dose intensity, and safety.
RESULTS: Twenty-eight patients were enrolled. Median age was 69.5 years, 54% of 
patients had synchronous metastases, and 29% were bilobar. Mean number of 
lesions resected was two, and mean size of the largest lesion was 31 mm. Among 
patients, 20 (71.4%; 95% confidence interval, 53.6%-89.3%) completed the 
protocol treatment and met its primary endpoint. The most common grade 3 or 
higher toxicity was neutropenia (29%). Five-year recurrence-free survival and 
overall survival were 65.2% and 87.2%, respectively.
CONCLUSION: Three-month adjuvant treatment with CAPOX is tolerable and might be 
a promising strategy for postcurative resection of CLM.