Surgical management of colorectal cancer metastases to the liver: multimodality approach and a single institutional experience

Abstract

SUMMARY Over the past 30 years, the treatment of metastatic colorectal cancer to the liver has undergone major changes. Once considered terminal and incurable, the prognosis of patients with colorectal hepatic metastases has seen dramatic improvements using modern multimodality therapy and now long-term survival and even cure are possible in some patients. Despite the advances seen in systemic therapy, hepatic resection offers the longest survival potential and remains the only curative option. Based on long-term outcomes and the improved safety of hepatic resection using modern operative techniques and critical care support, an aggressive locoregional approach to colorectal hepatic metastasis has become the standard of care. This article focuses on the management of colorectal hepatic metastases and highlights the importance of multimodality therapy. We also report our 18-year experience treating patients with hepatic resection for colorectal metastases.

Liver Resections in a High-Volume Center: Form Standard Procedures to Extreme Surgery and Ultrasound-guided Resections

“…Another major indication for LR in malignant liver tumors is represented by colorectal liver metastases (CLMs) (47). In patients with CLMs, resection is considered the gold standard treatment offering the highest rates of overall survival (48,49).…”

Intraoperative Ultrasound Guided Liver Resections: A Single Center Experience

“…The most common indication for LR was colorectal LM (33.3%), followed by HCC (22.2%), in accordance to published data (61). In case of colorectal LM, resection is considered the gold standard treatment and offers the best chance of long-term survival (62,63). In our experience, benign tumors represented only 13.1% of all LRs, hemangioma being the most frequent indication for LR among benign lesions (6.6%).…”

Colorectal cancer complicated by perforation. Specific features of surgical tactics

“…Неспецифичность ранней симптоматики КРР, длительное бессимптомное течение, недостаточная онкологическая настороженность врачей и поздняя диагностика приводят к тому, что 50-89 % пациентов поступают в хирургические стационары с осложнен-ным течением заболевания [3][4][5]9]. Одним из чрезвы-чайно тяжелых осложнений опухоли толстой кишки Онкологическая ONCOLOGY ТОМ 5 / VOL.…”

“…Существует несколько вариантов лечения КРР, осложненного перфорацией: резекция сегмента кишки с опухолью и формирование первичного анастомоза (риск несостоятельности анастомоза -до 98 %), резек-ция сегмента кишки с опухолью без восстановления естественного кишечного пассажа, ушивание перфо-рационного отверстия с оментопластикой и формиро-вание декомпрессионной колостомы [4,[6][7][8][9]10]. Таким образом, выбор хирургической тактики при данном заболевании продолжает оставаться одной из ключе-вых проблем [4,6,7,9].…”

“…Таким образом, выбор хирургической тактики при данном заболевании продолжает оставаться одной из ключе-вых проблем [4,6,7,9].…”