Management of hepatic metastasis from colorectal c

Authors: Sharad Sharma Cemalettin Camci Nicolas Jabbour

Publish Date: 2008/11/07

Volume: 15, Issue: 6, Pages: 570-580

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Abstract

Approximately 50–60 of patients with colorectal cancers will develop liver lesions in their life span Despite the potential of surgical resection to provide longterm survival in this subset of patients only 15–20 are found to be resectable The introduction of new neoadjuvant chemotherapeutic agents and the expanding criteria of resection have enhanced the overall 5year survival from 30 to 60 in the past decade The use of technical innovations such as staged resection portal vein embolization and repeat resection have allowed higher resection rates in patients with bilobar disease Extrahepatic primary and liverexclusive recurrent disease no longer represent an absolute contraindication to resection The role of regional therapy using hepatic arterial infusion is being redefined for liverexclusive unresectable disease Adjuvant chemotherapy in combination with regional therapies is being looked at from fresh perspectives Ablative approaches have gained a firm role both as an adjunct to surgical resection and in the management of patients who are not surgical candidates Overall the management of hepatic metastasis from colorectal cancers requires a multimodal approach

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