Shanghai international consensus on diagnosis and comprehensive treatment of colorectal liver metastases (version 2019)

Hepatic Steatosis Predicts Higher Incidence of Recurrence in Colorectal Cancer Liver Metastasis Patients

“…All radiological images were reviewed independently by two radiologists and disagreements were resolved through consensus. The exclusion criteria were as follows: (1) without histological diagnosis of colorectal adenocarcinoma, (2) did not achieve status of NED, (3) recurrent CRLM, (4) without routine postoperative surveillance, (5) without non-enhanced pretreatment CT images for steatosis assessment, (6) without active follow up of recurrence date. Recurrence-free survival (RFS) was defined as the number of months between the date of achieving NED and the date of recurrence of any organs (overall RFS) or hepatic recurrence (hepatic RFS) evaluated by radiological examinations.…”

“…However, colorectal liver metastasis (CRLM) is still the major cause of death due to CRC. About 50% CRC patients will develop liver metastasis over the course of their life (4), and the median survival time is 5-20 months for liver metastasis patients with no treatment (5). Locoregional treatment of surgical resection and radiofrequency ablation (RFA), and systemic neo-adjuvant treatment has been used to treat liver metastasis (6).…”

Nomogram including chemotherapy response for prediction of intrahepatic progression-free survival in patients with colorectal liver metastasis through chemotherapy followed by radiofrequency ablation

“…Colorectal cancer ranks as the third most common malignant tumor and has become the second leading cause of cancerrelated death worldwide [1]. With improved awareness and modern scanning techniques, nearly 80% of patients with colorectal cancer have developed colorectal liver metastases (CRLM) at diagnosis [2]. And, 60-80% of CRLM patients will have local recurrence or new intrahepatic metastases after R0 resection [3][4][5].…”

“…And, 60-80% of CRLM patients will have local recurrence or new intrahepatic metastases after R0 resection [3][4][5]. Although surgical resection remains the preferred treatment method for CRLM, most of these patients (about 70-90%) were not surgical candidates [6,7], and increasing evidence has demonstrated that liver metastases are the most common cause of death in patients with colorectal cancer [2]. For those with a liver-limited unresectable disease that, because of involvement of critical structures, cannot be resected unless regression is accomplished, systemic chemotherapy is being increasingly considered in an attempt to improve survival benefit or potentially convert patients with unresectable metastatic disease to resectability [8,9].…”

Centralized multidisciplinary team assessment of metastasis resectability in patients with metastatic colorectal cancer: A fundamental necessity

“…Considerable inconsistences exist amongst expert surgeons when choosing a therapeutic strategy for resection of CRC metastases [ 5 , 6 ]. This may confuse both patients and referring physicians and points out the need for an international high-level consensual statement and widely accepted guidelines [7] . While adjuvant chemotherapy improves OS for stage III CRC [8] , peri‑operative chemotherapy significantly increases disease-free survival (DFS), but not OS, for resectable metastatic CRC [9] .…”