Potential of a cure in patients with colorectal liver metastases and concomitant extrahepatic disease

Abstract

Even when concomitant EHD is present, a potential of cure could be achieved with aggressive oncosurgical approach.

Survival After Combined Hepatic Metastasectomy and Chemotherapy in Patients with Concurrent Hepatic and Extrahepatic Colorectal Metastases: A SEER Database Analysis.

“…The patients were rarely cured, and therefore, they considered liver resection in this setting as a noncurative intervention [19,27]. On the contrary, some have postulated that combining targeted molecular therapies with chemotherapy or following a more aggressive approach may offer a potential cure in CRLM patients with concomitant EHD [11,28]. Such an approach consists of perioperative chemotherapy, resection of all metastatic sites, and re-surgery in case of recurrence [11,28].…”

“…On the contrary, some have postulated that combining targeted molecular therapies with chemotherapy or following a more aggressive approach may offer a potential cure in CRLM patients with concomitant EHD [11,28]. Such an approach consists of perioperative chemotherapy, resection of all metastatic sites, and re-surgery in case of recurrence [11,28]. However, even in the absence of curative intent, complete resection is needed to achieve better outcomes.…”

Surgical resectability of multisite metastatic colorectal cancer: Pushing the limits while appropriately selecting patients

“…Resection of multisite metastases should aim to provide a long‐term cure. Imai et al performed an intention to treat analysis of all patients who underwent hepatectomy in the setting of extrahepatic metastatic disease at a single French institution. Cure, as defined by disease‐free survival at 5 years, was only achieved in 13% of patients in the intention to treat cohort and 19% of patients who underwent complete resection of all identified hepatic and extrahepatic disease.…”

“…On multivariate analysis, factors that were predictive of cure included T stages 1 and 2, metachronous liver metastases, low carbohydrate antigen 19‐9 at the time of hepatectomy, and four or fewer metastatic lesions. This may help define which patients are likely to have an improved long‐term outcome …”

Potential of a cure in patients with colorectal liver metastases and concomitant extrahepatic disease: Methodological issues

“…We read the paper authored by Imai et al that was published in Journal of Surgical Oncology , with great interest. The authors aimed to determine the cure rate and its predictive factors in patients with colorectal liver metastases and concomitant extrahepatic disease (EHD) on the 5‐year disease free survival (DFS) after surgery.…”