title: [Diagnosis and treatment of liver metastases from primary colorectal tumour].
abstract: Contrast-enhanced multislice computer tomography (MSCT) has established itself as the standard tomographic imaging method both for diagnosis and for treatment monitoring of hepatic lesions. To clarify local conditions before partial liver resection, diffusion-weighted magnetic resonance tomography (DWI-MRT) can also provide important additional information. In order to meet the criteria for a R0 resection, a margin of 0.5 mm seems to be sufficient. Neoadjuvant chemotherapy aiming to reduce tumour size can be given in parallel with portal artery embolisation without adversely affecting perioperative morbidity and mortality. As far as the management of primary resectable liver metastases is concerned, there is an urgent need for more studies. Despite the relatively limited evidence, adjuvant chemotherapy is currently more widely favoured in Germany than perioperative chemotherapy. There is also considerable need for studies concerning preoperative therapy in patients with liver metastases that are not (yet) resectable. In KRAS wild-type tumours, high response rates (in terms of a reduction in the size of metastases) are achieved with a cetuximab/chemotherapy combination. Bevacizumab/chemotherapy combinations lead to high rates of pathohistological complete and partial remissions. What the best parameter for judging the success of preoperative therapy is remains unknown, and so comparison studies using survival as a 'hard' endpoint must be carried out.
authors: Klinik und Poliklinik für Innere Medizin IV, Abteilung für Onkologie und Hämatologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Saale, Deutschland.
authors: Dirk
authors: D
authors: Arnold
authors: Ernst J
authors: EJ
authors: Rummeny
authors: Thomas
authors: T
authors: Kirchner
authors: Karsten
authors: K
authors: Ridwelski
authors: Helmut
authors: H
authors: Oettle
authors: Jörg Thomas
authors: JT
authors: Hartmann
authors: Markus
authors: M
authors: Moehler
authors: Arnulf
authors: A
authors: Hölscher
authors: Hauke
authors: H
authors: Lang
authors: Hans J
authors: HJ
authors: Schlitt
authors: Peter
authors: P
authors: Neuhaus
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000628:therapy