title: Treatment of Liver Metastases From Colorectal Cancer: Medico-Surgical Strategies.
abstract: BACKGROUND
  The management of hepatic metastases from colorectal cancer can be understood only as part of a multidisciplinary strategy. Progress experienced by medical treatment, surgical techniques and ways of imaging, has improved the prognosis of patients with liver metastases of colorectal cancers. This work displays the experience of Medical Oncology unit at the Military training hospital in Rabat.
  
  
  METHODS
  From January 2007 to December 2009, 60 patients with liver metastases from colorectal cancer, synchronous or metachronous were supported in the Medical Oncology unit at the Military training hospital in Rabat.
  
  
  RESULTS
  Liver metastases were synchronous in 41 (68%) patients and metachronous in 19 (32%). Patients were classified into 3 categories according to their resectability: 14 (22%) were resectable at the outset, 28 (47%) were unresectable and 18 (31%) were considered uncertain resectability. Thirty-five patients (58%) received neoadjuvant chemotherapy before surgical gesture, 25 (42%) received chemotherapy after resection of primary tumor. This chemotherapy enabled the resection of liver metastases in 5 patients initially deemed uncertain resectability. The average objective responses to chemotherapy were in the range of 59% with 4 complete responses and one confirmed histologically. Twenty-three patients (38%) underwent surgery including 15 liver resections with R0 (25%). The median progression-free survival in this series was 15.5 months. Some minor side effects were noted, which have not entered the prognosis of patients.
  
  
  CONCLUSIONS
  Hepatic resection remains the only potentially curative treatment of liver metastases of colorectal cancers. Perioperative chemotherapy is a promising standard, which has improved the prognosis of patients historically associated with a poor prognosis.
authors.affiliation: Department of Medical Oncology at the Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: Ismail
authors.initials: I
authors.lastname: Essadi
authors.affiliation: Department of Medical Oncology at the Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: Yassir
authors.initials: Y
authors.lastname: Sbitti
authors.affiliation: Department of Medical Oncology at the Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fetohi
authors.affiliation: Department of Medical Oncology at the Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: Khaoula Alaoui
authors.initials: KA
authors.lastname: Slimani
authors.affiliation: National Institute of Statistics and Applied Economics (INSEA), Rabat, Morocco.
authors.forename: Meryam
authors.initials: M
authors.lastname: Essadi
authors.affiliation: Department of Medical Oncology at the National Institute of Oncology, Rabat, Morocco.
authors.forename: Elmehdi
authors.initials: E
authors.lastname: Tazi
authors.affiliation: Department of Medical Oncology at the Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Ichou
authors.affiliation: Department of Medical Oncology at the National Institute of Oncology, Rabat, Morocco.
authors.forename: Hassan
authors.initials: H
authors.lastname: Errihani
keywords: Chemotherapy; Colorectal cancer; Liver; Metastasis; Radiofrequency; Surgery