Management of hepatic metastasis from colorectal cancers: an update.
Approximately 50%-60% of patients with colorectal cancers will develop liver lesions in their life span. Despite the potential of surgical resection to provide long-term survival in this subset of patients, only 15%-20% are found to be resectable. The introduction of new neoadjuvant chemotherapeutic agents and the expanding criteria of resection have enhanced the overall 5-year survival from 30% to 60% in the past decade. The use of technical innovations such as staged resection; portal vein embolization, and repeat resection have allowed higher resection rates in patients with bilobar disease. Extrahepatic primary and liver-exclusive recurrent disease no longer represent an absolute contraindication to resection. The role of regional therapy using hepatic arterial infusion is being redefined for liver-exclusive unresectable disease. Adjuvant chemotherapy in combination with regional therapies is being looked at from fresh perspectives. Ablative approaches have gained a firm role both as an adjunct to surgical resection and in the management of patients who are not surgical candidates. Overall, the management of hepatic metastasis from colorectal cancers requires a multimodal approach.
Sharma
Sharad
S
Nazih Zuhdi Transplant Institute, 3300 North West Expressway, Oklahoma, OK 73112, USA.
Camci
Cemalettin
C
Jabbour
Nicolas
N
D000970:Antineoplastic Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D004621:Embolization, Therapeutic; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging
D000970:Antineoplastic Agents