Developing strategies for liver metastases from colorectal cancer.
Five-year survival rates of patients with liver metastases from colorectal cancer range from 30% to 40% for those who undergo successful resection procedures, and is almost nil among those unable to have surgery. However, improved chemotherapy strategies for nonoperable patients (specifically, the use of neoadjuvant oxaliplatin- and irinotecan-based regimens) have increased response rates and tumor downstaging such that 15% to 30% of initially nonoperable patients are able to have secondary, or rescue, surgery. Preliminary data also indicate that new targeted therapies should further increase response rates and thus resection rates. Operative techniques such as portal vein embolization and two-stage procedures for patients with multiple or large tumors, as well as use of cryosurgery and radiofrequency ablation, are also contributing to more effective removal of liver metastases from colorectal cancer. This brief report describes data supporting the expanding application of hepatectomy for patients with colorectal liver metastases.
Adam
René
R
Hôpital Paul Brousse, Assistance Publique-Hopitaux de Paris, University Paris Sud 11, 14 Avenue Paul Vaillant Couturier, 94800 Villejuif, Paris, France. rene.adam@pbr.ap-hop-paris.fr
D000970:Antineoplastic Agents / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D017115:Catheter Ablation; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000473:pathology*; D003452:Cryosurgery; D004621:Embolization, Therapeutic; D006498:Hepatectomy; D006801:Humans; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D020360:Neoadjuvant Therapy; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D011169:Portal Vein; D012004:Rectal Neoplasms / Q000473:pathology*; D012074:Remission Induction; D015996:Survival Rate; D013997:Time Factors; D059004:Topoisomerase I Inhibitors
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D009944:Organoplatinum Compounds; D059004:Topoisomerase I Inhibitors; D000077150:Oxaliplatin; D000077146:Irinotecan; D002166:Camptothecin