Optimizing the approach to patients with potentially resectable liver metastases from colorectal cancer
Details
Publication Year 2007-11,Volume 77,Issue #11,Page 941-947
Journal Title
ANZ JOURNAL OF SURGERY
Publication Type
Journal Article
Abstract
Liver metastases are a common event in colorectal carcinoma. Significant advances have been made in managing these patients in the last decade, including improvements in staging and surgical techniques, an increasing armamentarium of chemotherapeutics and multiple local ablative techniques. While combination chemotherapy significantly improves median patient survival, surgical resection provides the only prospect of cure and is the focus of this review. Interpretation of published work in this field is challenging, particularly as there is no consensus to what is resectable disease. Of particular interest recently has been the use of neoadjuvant treatment for downstaging and downsizing disease in patients with initially unresectable liver metastases, in the hope of response leading to potentially curative surgery. This review summarizes the recent developments and consensus guidelines in the areas of staging, chemotherapy, local ablative techniques, radiation therapy and surgery, emphasizing the multidisciplinary approach to this disease and ongoing controversies in this field and examines the changing paradigms in the management of colorectal hepatic metastases.
Publisher
BLACKWELL PUBLISHING
Keywords
POSITRON-EMISSION-TOMOGRAPHY; SYNCHRONOUS PERITONEAL CARCINOMATOSIS; PORTAL-VEIN EMBOLIZATION; HEPATIC RESECTION; NEOADJUVANT CHEMOTHERAPY; RADIOFREQUENCY ABLATION; DIAGNOSTIC LAPAROSCOPY; EXTENDED HEPATECTOMY; RADIATION-THERAPY; RANDOMIZED-TRIAL
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Creation Date: 2007-11-01 12:00:00
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