title: Pooled analysis of the surgical treatment for colorectal cancer liver metastases.
abstract: Liver metastases in colorectal cancer patients decreases the expected 5 year survival rates by a factor close to nine. It is generally accepted that resection of liver metastases should be attempted whenever feasible. This manuscript addresses the optimal therapeutic plan regarding timing of resection of synchronous liver metastases and the use of chemotherapy in combination with resection of synchronous metachronous liver metastases. The aim is to pool all published results in order to attribute a level of evidence to outcomes and identify lacking evidence areas. A systematic search of guidelines, reviews, randomised controlled, observational studies and updating a meta-analysis was performed. Data were extracted and analysed. Data failed to demonstrate an effect of timing of surgery or use of chemotherapy on overall survival. Concomitant resection of liver metastases and the primary tumour may result in lower postoperative morbidity. Systemic peri-operative chemotherapy may improve progression free survival compared to surgery alone.
authors: Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
authors: G
authors: G
authors: Veereman
authors: Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
authors: J
authors: J
authors: Robays
authors: Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
authors: L
authors: L
authors: Verleye
authors: Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium.
authors: R
authors: R
authors: Leroy
authors: Department of Digestive Oncology, University Hospital Antwerp (UZA), Edegem, Belgium. Electronic address: christian.rolfo@uza.be.
authors: C
authors: C
authors: Rolfo
authors: Department of Digestive Oncology, University Hospitals Leuven (UZLeuven), Leuven, Belgium.
authors: E
authors: E
authors: Van Cutsem
authors: Department of Radiology, University Hospitals Leuven (UZLeuven), Leuven, Belgium.
authors: D
authors: D
authors: Bielen
authors: Department of Digestive Surgery, University Hospital Gent (UZ Gent), Gent, Belgium.
authors: W
authors: W
authors: Ceelen
authors: Department of Radiology, Catholic University Leuven (UCL), Woluwe, Belgium.
authors: E
authors: E
authors: Danse
authors: Department of Digestive Oncology, OLV Ziekenhuis, Aalst, Belgium.
authors: M
authors: M
authors: De Man
authors: Department of Pathology, Free University Brussels (ULB), Brussels, Belgium.
authors: P
authors: P
authors: Demetter
authors: Department of Nuclear Medicine, Jules Bordet Institute, Brussels, Belgium.
authors: P
authors: P
authors: Flamen
authors: Department of Digestive Oncology, Jules Bordet Institute, Brussels, Belgium.
authors: A
authors: A
authors: Hendlisz
authors: Department of Oncology, Grand Hôpital de Charleroi, Charleroi, Belgium.
authors: I
authors: I
authors: Sinapi
authors: Department of Radiology, University Hospitals Leuven (UZLeuven), Leuven, Belgium.
authors: D
authors: D
authors: Vanbeckevoort
authors: Department of Hepatobiliary Surgery, University Hospital Antwerp (UZA), Edegem, Belgium.
authors: D
authors: D
authors: Ysebaert
authors: Department of Digestive Oncology, University Hospital Antwerp (UZA), Edegem, Belgium.
authors: M
authors: M
authors: Peeters
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000601:surgery* / Q000628:therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal cancer; Hepatic metastasis; Liver metastasis; Metachronous metastasis; Synchronous metastasis