title: Neoadjuvant and adjuvant therapy in relation to surgery for colorectal liver metastases.
abstract: Liver resection is associated with prolonged survival in patients with colorectal liver metastases. At diagnosis, 15-20% of patients have resectable colorectal liver metastases whereas other patients have too advanced disease to enable surgical treatment and receive chemotherapy. In patients undergoing resection of colorectal liver metastases, disease relapse occurs in up to 70%. Therefore, a combined approach including preoperative or postoperative chemotherapy or both has been tested to improve outcome after surgery. In patients with unresectable colorectal liver metastases, chemotherapy is initially the sole treatment option. The considerable improvement of the efficacy of anticancer agents has contributed to increase the response rate in patients with advanced colorectal cancer. In case of major response to chemotherapy, surgery with curative intent can be offered to patients with initially unresectable liver metastases.
authors.affiliation: Department Digestive and Oncologic Surgery, AP-HP, Université Versailles Saint Quentin en Yvelines, Hôpital Ambroise Paré, Versailles, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Brouquet
authors.forename: Bernard
authors.initials: B
authors.lastname: Nordlinger
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery*; D018450:Disease Progression; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D020360:Neoadjuvant Therapy; D016019:Survival Analysis