ASO Author Reflections: Selected Multisite Metastatic Colorectal Cancer Patients May Benefit from Radical Multimodal Treatment

Excerpt

Half of colorectal cancer patients present at diagnosis with metastases.¹ Together with the progress of systemic and locoregional treatments, curative-intent strategies have been developed on the basis of a comprehensive approach combining systemic and locoregional chemotherapies and radical resection or destruction of all detectable metastases.² Elaboration of these strategies is demanding, as it requires the ability to identify all metastases, confirm chemosensitivity, and perform complete treatment with controlled post-interventional morbidity and mortality, guaranteeing correct quality of life.² As oncologic outcomes are encouraging, there is a trend to extend the boundaries of resectability to include a larger proportion of patients in such strategies.³ Progressively, patients with several metastatic sites, in particular liver and peritoneum, are considered for these multimodal radical treatments.⁴ These strategies are highly demanding for patients and for physicians. Thus, the most important pitfall is early recurrence, meaning treatment failure with no sufficient treatment-free interval for the patients. There is a need for accurate selection criteria to select the best candidates for such ambitious strategies. …