The management of colorectal liver metastases: Expanding the role of hepatic resection in the age of multimodal therapy.
Colorectal cancer (CRC) caused nearly 204,000 deaths in Europe in 2004. Despite recent advances in the treatment of advanced disease, which include the incorporation of two new cytotoxic agents irinotecan and oxaliplatin into first-line regimens, the concept of planned sequential therapy involving three active agents during the course of a patient's treatment and the integrated use of targeted monoclonal antibodies, the 5-year survival rates for patients with advanced CRC remain unacceptably low. For patients with colorectal liver metastases, liver resection offers the only potential for cure. This review, based on the outcomes of a meeting of European experts (surgeons and medical oncologists), considers the current treatment strategies available to patients with CRC liver metastases, the criteria for the selection of those patients most likely to benefit and suggests where future progress may occur.
Chiappa
A
A
Department of General Surgery-Laparoscopic Surgery, University of Milano, European Institute of Oncology, Milano, Italy. antonio.chiappa@unimi.it
Makuuchi
M
M
Lygidakis
N J
NJ
Zbar
A P
AP
Chong
G
G
Bertani
E
E
Sitzler
P J
PJ
Biffi
R
R
Pace
U
U
Bianchi
P P
PP
Contino
G
G
Misitano
P
P
Orsi
F
F
Travaini
L
L
Trifirò
G
G
Zampino
M G
MG
Fazio
N
N
Goldhirsch
A
A
Andreoni
B
B
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D020360:Neoadjuvant Therapy; D017410:Practice Guidelines as Topic
D000970:Antineoplastic Agents