title: Curative strategies for liver metastases from colorectal cancer: a review.
abstract: Colorectal cancer is a very common malignancy and frequently manifests with liver metastases, often without other systemic disease. Margin-negative (R0) resection of limited metastatic disease, in conjunction with systemic antineoplastic agents, is the primary treatment strategy, leading to long survival times for appropriately selected patients. There is debate over whether the primary tumor and secondaries should be removed at the same time or in a staged manner. Chemotherapy is effective in converting some unresectable liver metastases into resectable disease, with a correspondingly better survival outcome. However, the ideal chemotherapy with or without biological agents and when it should be administered in the course of treatment are uncertain. The role of neoadjuvant chemotherapy in initially resectable liver metastases is controversial. Local delivery of chemotherapy, with and without surgery, can lead to longer disease-free survival times, but it is not routinely used with curative intent. This review focuses on methods to maximize the disease-free survival interval using chemotherapy, surgery, and local methods.
authors.affiliation: Department of Medical Oncology, Calvary Mater Hospital, Locked Bag No 7, Hunter Regional Mail Centre, Newcastle, NSW, 2310 Australia. Nicholas.zdenkowski@calvarymater.org.au
authors.forename: Nicholas
authors.initials: N
authors.lastname: Zdenkowski
authors.forename: Stanley
authors.initials: S
authors.lastname: Chen
authors.forename: Andre
authors.initials: A
authors.lastname: van der Westhuizen
authors.forename: Stephen
authors.initials: S
authors.lastname: Ackland
mesh_terms: D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011183:Postoperative Complications / Q000453:epidemiology; D014057:Tomography, X-Ray Computed