[Colorectal cancer liver metastases -- neoadjuvant concepts for preoperative down-sizing].
Liver resection for colorectal metastases disease can be performed with curative intent at low morbidity and mortality. Only 15-30 % of liver metastases are amenable to potentially curative resection. Five year survival following primary and repeat liver resection has consistently been reported as 25-40 %. Future strategies focus at widening the indication and extending therapeutic options. The aim of neoadjuvant treatment of irresectable liver metastasis is the conversion to secondary resectability either via increasing residual liver mass (portal vein embolisation/2-stage resection) and/or reducing tumor load via chemotherapy ("down-sizing"). Current data suggest resectability following neoadjuvant chemotherapy in around 8 % of cases but varying between 1-33 %.
Golling
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Klinik für Allgemein- und Gefässchirurgie, Chirurgischen Universitätsklinik der Johann Wolfgang Goethe-Universität, Frankfurt/Main. Markus.Golling@kgu.de
Gog
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Woeste
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G
Zapletal
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Wullstein
C
C
Bechstein
W O
WO
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D012086:Reoperation; D015996:Survival Rate