Timing of Resection for Synchronous Liver Metastases from Colorectal Cancer

Abstract

Tumor progression could be recognized and occult metastases were detected during the interval between operations. Delayed resection of synchronous LM may be useful to reduce the risk of rapid recurrence in the remnant liver. Patients with poorly differentiated or mucinous adenocarcinoma and those with larger tumors who undergo delayed liver resection should receive neoadjuvant chemotherapy during the interval between operations.

Systematic review of surgical management of synchronous colorectal liver metastases

“…One study suggested a better 5‐year survival rate after staged procedures (60 per cent versus 43 per cent for simultaneous procedures), and another suggested worse 1‐year but better 3‐ and 5‐year survival rates after a simultaneous approach (78, 70 and 45 per cent respectively versus 88, 55 and 38 per cent following staged procedures) ( Table S3 , supporting information).…”

Plasma chitinase 3-like 1 is persistently elevated during first month after minimally invasive colorectal cancer resection

“…In particular, rapid growth of preexisting metastatic cancer in the liver after resection of the primary colorectal tumor has been noted by several investigators [6,[50][51][52] . Of note, in one investigation the vascular density of metastases has been noted to be significantly increased over the pre-resection baseline several months after primary resection; this suggests that tumor angiogenesis is stimulated after surgery [53] .…”

The preliminary experience in simultaneous treatment of rectal cancer and synchronous liver metastases with laparoscopy

“…This modality can be used in an attempt to convert unresectable tumors into potentially resectable ones. The down-staging treatment for unresectable tumors includes portal vein embolization (PVE) or PVL (inducing residual liver hypertrophy), local ablation of the tumor, and simultaneous neoadjuvant chemotherapy (20)(21)(22). These surgical procedures can be performed easily by laparoscopy.…”