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Title of Journal: J Hepatobiliary Pancreat Surg

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Abbravation: Journal of Hepato-Biliary-Pancreatic Surgery

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Springer Japan

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Management of hepatic metastasis from colorectal cancers: an update

Authors: Sharad Sharma, Cemalettin Camci, Nicolas Jabbour,

Publish Date: 2008/11/07
Volume: 15, Issue:6, Pages: 570-580
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Approximately 50%–60% of patients with colorectal cancers will develop liver lesions in their life span. Despite the potential of surgical resection to provide long-term 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 5-year 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 Extrahepatic primary and liver-exclusive recurrent disease no longer represent an absolute contraindication to resection. The role of regional therapy using hepatic arterial infusion is being redefined for liver-exclusive 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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