[The therapy of the liver metastases of colorectal carcinoma].
The treatment of liver metastases should be addressed in a multidisciplinary way, considering the manifold therapeutic options available, for each of which corresponds a particular indication. The best results are obtainable with resective surgery in cases in which there is a partial involvement of the liver (25-50%) and a variable intra-hepatic distribution (monolobar), situations that correspond to Gennari stages I and II. In the authors' experience, the extent of the liver resection does not influence possible survival and oncologically correct resections should be carried out such as segmentectomies, pluri-segmentectomies or wedge resection in compliance with the principle of removing at least 1.5 cm of healthy perineoplastic tissue. The authors reserve major hepatectomies to special situations: voluminous metastases, diffuse involvement of a single lobe, topographic localisation contraindicating segmentary resection.
Spagliardi
E
E
II Divisione Chirurgia Generale, Ospedale San Martino, Genova.
Torelli
P
P
Barra
M
M
Orsi
D
D
Bruzzo
F
F
D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D003131:Combined Modality Therapy; D000431:Ethanol / Q000008:administration & dosage; D005467:Floxuridine / Q000008:administration & dosage; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis
D005467:Floxuridine; D000431:Ethanol