Current management of colorectal hepatic metastasis

Abstract

In the USA, cancers of the colon and rectum are the third most common site of new cancer cases and cancer deaths. With improved screening and adjuvant therapy, the survival of patients has increased substantially over the last decade. However, patients with metastatic disease often have limited survival. Hepatic metastasis is one of the most frequent sites of metastatic disease. In fact, 35-55% of patients with colorectal cancer will develop hepatic metastasis at some time during the course of their disease. Patients who are able to undergo complete resection of their hepatic metastases have the best chance of long-term survival. The goal of hepatic resection is to achieve complete resection of all metastases with microscopically negative surgical margins while preserving sufficient hepatic parenchyma. Survival following hepatic resection of colorectal metastasis now approaches 35-50%. However, approximately 65% of patients will have a recurrence at 5 years. Increasingly chemotherapeutic agents are being offered in the preoperative setting prior to operation. At the time of operation, patients with extensive hepatic disease can sometimes be offered ablative therapies combined with resection or staged approaches. Modern management of hepatic colorectal metastases necessitates a multidisciplinary approach to effectively treat these patients and increase the number of patients who will benefit from resection.

Safety of Repeated Radioembolizations in Patients with Advanced Primary and Secondary Liver Tumors and Progressive Disease After First Selective Internal Radiotherapy

“…Thel iver is a common site of metastasis in various tumors, for example, colorectal cancer or breast cancer (1,2). Unfortunately, most patients with liver metastasis will face advanced-stage disease, lacking curative options.…”

Expression of Smoothened Protein in Colon Cancer and its Prognostic Value for Postoperative Liver Metastasis

“…Survival following hepatic resection of colorectal metastasis now approaches 35%-50%. However, the recurrence rate in 5 years is as high as approximately 65% (Mayo and Pawlik, 2009). Early treatment targeting colon cancer liver metastatic foci might be important for improving patient survival.…”

The results of surgical treatment of metastatic liver tumor

“…A one-year survival in patients with colorectal metastases, in our study was 86.96% and a threeyear survival 50%. Data from the other authors show a one-year survival of up to 90% and, even, 65% for a one-year and three-year survival (18,19). The role of liver resection in case of non-colorectal primary tumors is less known.…”