title: The Tower of Babel of liver metastases from colorectal cancer: are we ready for one language?
abstract: Advances in surgical and medical treatments have significantly changed the management of colorectal cancer liver metastases (CRCLMs). In particular, new drugs and modern combination chemotherapy regimens, together with the improvement of surgical techniques, allow a potentially curative approach in an increasing number of patients. Nevertheless, there is no strong evidence for an optimal treatment strategy for CRCLMs, mainly because of the extensive heterogeneity in the patients. In fact, although we consider them a population, they represent different clinical and biological subtypes requiring different approaches. Furthermore, results from different studies in this setting may be difficult to interpret, also because the definitions of different patient subgroups are unclear and overlapping. In this review we discuss the results of clinical trials evaluating the role of chemotherapy in the multimodal management of CRCLMs, in either the pre- or postoperative setting. Then we identify three main categories of CRCLM patients, providing clinical recommendations for each.
authors.affiliation: Scuola di Specializzazione in Oncologia, Università Politecnica delle Marche, Via Tronto 10/A, 60100 Ancona, Italy. alebitto@tiscali.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bittoni
authors.forename: Mario
authors.initials: M
authors.lastname: Scartozzi
authors.forename: Riccardo
authors.initials: R
authors.lastname: Giampieri
authors.forename: Luca
authors.initials: L
authors.lastname: Faloppi
authors.forename: Elena
authors.initials: E
authors.lastname: Maccaroni
authors.forename: Michela
authors.initials: M
authors.lastname: Del Prete
authors.forename: Maristella
authors.initials: M
authors.lastname: Bianconi
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents