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Published in: Langenbeck's Archives of Surgery 6/2009

01-11-2009 | Current Concepts in Clinical Surgery

Treatment for colorectal liver metastases: a review

Authors: Hiroshi Shimada, Kuniya Tanaka, Itaru Endou, Yasushi Ichikawa

Published in: Langenbeck's Archives of Surgery | Issue 6/2009

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Abstract

Introduction

Over the past decade, the emergence of surgical adjuncts such as portal vein embolization, two-stage hepatectomy, and ablative therapies not only decreases mortality and morbidity after an extended hepatectomy but also broadens the indication for surgical treatment of liver metastasis from colorectal cancer. Combination chemotherapeutic regimens, namely 5-fluorouracil/folinic acid with irinotecan or oxaliplatin, and targeted monochromal antibodies can downsize the tumor burden to the extent that formerly unresectable metastases can sometimes be excised.

Discussion

The 5-year survival rate following liver resection ranges between 25% and 58%. During the 5-fluorouracil/folinic acid with oxaliplatin and 5-fluorouracil/folinic acid with irinotecan treatment period, the patients who were deemed to be resectable should be considered as surgical candidates regardless of the associated adverse predictive factors. The emergence of epidermal growth factor receptor antibody agents, which act effectively in patients with Kras wild-type tumor, fosters treatment individualization.

Conclusion

The efficacy of the perioperative chemotherapy on survival benefit for resectable liver metastases has not been justified. However, the timing and indication of surgical treatment paradigm in colorectal liver metastasis, including for synchronous disease and extrahepatic disease, are dramatically changing with the development of chemotherapeutic agents.
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Metadata
Title
Treatment for colorectal liver metastases: a review
Authors
Hiroshi Shimada
Kuniya Tanaka
Itaru Endou
Yasushi Ichikawa
Publication date
01-11-2009
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 6/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-009-0530-8

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