Multisciplinary management of patients with liver metastasis from colorectal cancer.
Colorectal cancer (CRC) is one of the leading causes of cancer-related death. Surgery, radiotherapy and chemotherapy have been till now the main therapeutic strategies for disease control and improvement of the overall survival. Twenty-five per cent (25%) of CRC patients have clinically detectable liver metastases at the initial diagnosis and approximately 50% develop liver metastases during their disease course. Twenty-thirty per cent (20%-30%) are CRC patients with metastases confined to the liver. Some years ago various studies showed a curative potential for liver metastases resection. For this reason some authors proposed the conversion of unresectable liver metastases to resectable to achieve cure. Since those results were published, a lot of regimens have been studied for resectability potential. Better results could be obtained by the combination of chemotherapy with targeted drugs, such as anti-VEGF and anti-EGFR monoclonal antibodies. However an accurate selection for patients to treat with these regimens and to operate for liver metastases is mandatory to reduce the risk of complications. A multidisciplinary team approach represents the best way for a proper patient management. The team needs to include surgeons, oncologists, diagnostic and interventional radiologists with expertise in hepatobiliary disease, molecular pathologists, and clinical nurse specialists. This review summarizes the most important findings on surgery and systemic treatment of CRC-related liver metastases.
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Kathleen
K
De Greef
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Christian
C
Rolfo
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Antonio
A
Russo
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Thiery
T
Chapelle
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Giuseppe
G
Bronte
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Francesco
F
Passiglia
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Andreia
A
Coelho
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Konstantinos
K
Papadimitriou
Kathleen De Greef, Thiery Chapelle, Hepatobiliary, Transplant and endocrine surgery Department, Antwerp University Hospital, 2650 Edegem, Belgium.
Marc
M
Peeters
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D015179:Colorectal Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy; D019468:Disease Management; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy*
D020533:Angiogenesis Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors
Chemotherapy; Colorectal cancer; Liver metastases; Liver resection; Multidisciplinary team