The role of peri-operative treatment in resectable liver metastases of colorectal cancer.

TY - JOUR

T1 - The role of peri-operative treatment in resectable liver metastases of colorectal cancer.

AU - Stein, Alexander

AU - Rüssel, Joern

AU - Peinert, Stefan

AU - Arnold, Dirk

PY - 2010

Y1 - 2010

N2 - Synchronous or metachronous colorectal liver metastases (CLMs), although being the expression of systemic disease, allow a curative approach for about 25-35% of patients. Patients presenting with CLMs should receive a multimodal management in order to increase the number of patients undergoing R0 surgery and to decrease the rate of recurrence. Postoperative and/or pre-operative systemic chemotherapy shows beneficial impact regarding progression-free and overall survival, without increasing postoperative complication rates. Concerning the complex definition of resectability and the number of patients with 'borderline' resectable CLMs, pre-operative chemotherapy plays an important role in both the improvement of prognosis and 'conversion' to resectability. Duration of chemotherapy in the peri-operative setting should not exceed 6 months. Current data do not recommend the use of locally applied chemotherapy using hepatic artery infusion after resection of CLMs. Liver surgery has made several advances extending resectability to a larger group of patients and decreasing local hepatic recurrence. Moreover, locally ablative procedures such as radiofrequency and selective internal radiation therapy have joined the armamentarium in the case of positive resection margins or unresectable disease. Future research will help in defining treatment regimens and approaches in this setting.

AB - Synchronous or metachronous colorectal liver metastases (CLMs), although being the expression of systemic disease, allow a curative approach for about 25-35% of patients. Patients presenting with CLMs should receive a multimodal management in order to increase the number of patients undergoing R0 surgery and to decrease the rate of recurrence. Postoperative and/or pre-operative systemic chemotherapy shows beneficial impact regarding progression-free and overall survival, without increasing postoperative complication rates. Concerning the complex definition of resectability and the number of patients with 'borderline' resectable CLMs, pre-operative chemotherapy plays an important role in both the improvement of prognosis and 'conversion' to resectability. Duration of chemotherapy in the peri-operative setting should not exceed 6 months. Current data do not recommend the use of locally applied chemotherapy using hepatic artery infusion after resection of CLMs. Liver surgery has made several advances extending resectability to a larger group of patients and decreasing local hepatic recurrence. Moreover, locally ablative procedures such as radiofrequency and selective internal radiation therapy have joined the armamentarium in the case of positive resection margins or unresectable disease. Future research will help in defining treatment regimens and approaches in this setting.

U2 - 10.1177/1758834010375095

DO - 10.1177/1758834010375095

M3 - SCORING: Zeitschriftenaufsatz

VL - 2

SP - 389

EP - 398

JO - THER ADV MED ONCOL

JF - THER ADV MED ONCOL

SN - 1758-8340

IS - 6

M1 - 6

ER -