Treatment of colorectal cancer: hepatic metastasis.
Almost one-third of patients dying from colorectal cancer have tumor limited to the liver. Systemic chemotherapy is the appropriate palliative management of patients with metastases to the liver and other sites. For many patients with isolated hepatic metastases, systemic chemotherapy is also the most appropriate treatment. However, results with systemic chemotherapy indicate that one-third or less of patients will respond to such treatments, and long-term survival is rare. In this report we provide information concerning the natural history of colorectal hepatic metastases, followed by the expected benefits with systemic chemotherapy. This information provides background for the regional therapeutic strategies of surgical resection, cryosurgery, and hepatic artery chemotherapy. We discuss the selection factors appropriate for such treatments, morbidity and mortality, and the potential long-term benefits of such approaches. The last section focuses on surgical considerations in hepatic resection and hepatic artery chemotherapy.
Fong
Y
Y
Colorectal Service, Department of Surgery, Gastrointestinal Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Kemeny
N
N
Paty
P
P
Blumgart
L H
LH
Cohen
A M
AM
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D010478:Chemotherapy, Cancer, Regional Perfusion; D003110:Colonic Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D003452:Cryosurgery; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D010166:Palliative Care; D018579:Patient Selection; D011379:Prognosis; D012004:Rectal Neoplasms / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
D000970:Antineoplastic Agents