title: Evidence-based medical oncology and interventional radiology paradigms for liver-dominant colorectal cancer metastases.
abstract: Colorectal cancer metastasizes predictably, with liver predominance in most cases. Because liver involvement has been shown to be a major determinant of survival in this population, liver-directed therapies are increasingly considered even in cases where there is (limited) extrahepatic disease. Unfortunately, these patients carry a known risk of recurrence in the liver regardless of initial therapy choice. Therefore, there is a demand for minimally invasive, non-surgical, personalized cancer treatments to preserve quality of life in the induction, consolidation, and maintenance phases of cancer therapy. This report aims to review evidence-based conceptual, pharmacological, and technological paradigm shifts in parenteral and percutaneous treatment strategies as well as forthcoming evidence regarding next-generation systemic, locoregional, and local treatment approaches for this patient population.
authors.affiliation: Alan Alper Sag, Division of Interventional Radiology, Department of Radiology, Koc University School of Medicine, Istanbul 34450, Turkey.
authors.forename: Alan Alper
authors.initials: AA
authors.lastname: Sag
authors.affiliation: Alan Alper Sag, Division of Interventional Radiology, Department of Radiology, Koc University School of Medicine, Istanbul 34450, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Selcukbiricik
authors.affiliation: Alan Alper Sag, Division of Interventional Radiology, Department of Radiology, Koc University School of Medicine, Istanbul 34450, Turkey.
authors.forename: Nil Molinas
authors.initials: NM
authors.lastname: Mandel
mesh_terms: D055011:Ablation Techniques; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016461:Chemoembolization, Therapeutic; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D007167:Immunotherapy; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D008495:Medical Oncology; D009367:Neoplasm Staging; D015641:Radiography, Interventional; D015642:Radiology, Interventional; D016896:Treatment Outcome
keywords: Antineoplastic agents; Chemoembolization; Colonic neoplasms; FOLFOX protocol; Immunotherapy; Irinotecan, 5-flurouracil, and leucovorin protocol; Microwave ablation; Neoplasm metastasis; Radiofrequency ablation; Rectal neoplasms; Therapeutic