Do colorectal cancer patients with hyperbilirubinemia and liver metastases benefi t from chemotherapy? Methods/Results: This study entailed a review of 3,019 consecutive patients with colorectal cancer. Within this cohort, 20 met the study's a priori selection criteria, which included a new diagnosis of colorectal cancer, no prior therapy, and a total bilirubin of Ն3.0 mg/dL. All 20 patients had liver metastases, and as a whole the group had a median serum bilirubin of 6.4 mg/dL (range 3.1, 28

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... g/dL). Six patients received chemotherapy with an oxaliplatincontaining regimen, and four subsequently sustained a drop in their bilirubin. In one instance, a drop from 27.2 to 2.5 mg/dL occurred. These six patients lived a median of 71 days (range 23+, 283 days), but one treatment-related death occurred. In contrast, patients who received only supportive care lived a median of 28 days. Conclusion: Chemotherapy appears to provide modest benefi t to newly diagnosed colorectal cancer patients with severe hyperbilirubinemia.