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Colorectal metastases to the liver: Present results and future strategies
Author(s) -
Lise Mario,
Pian Pier Paolo Da,
Nitti Donato,
Pilati Pier Luigi
Publication year - 1991
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930480516
Subject(s) - medicine , colorectal cancer , chemotherapy , randomized controlled trial , prospective cohort study , surgery , hepatic arterial infusion , cancer , oncology
In recent years, wide agreement has been expressed on the value of surgical resection for liver metastases from colorectal cancer, while for unresectable patients different types of locoregional treatment have been attempted. One hundred seventy‐one patients with hepatic metastases from colorectal cancer were treated by us over a period of 15 years. Sixty‐four underwent hepatic resection, and 107 underwent various forms of locoregional treatment. Our experience confirms the opinion that hepatic resection can be performed with a „curative” aim in patients with colorectal liver metastases; a 5‐year survival rate can be achieved in about 30% of resectable cases. Adjuvant chemotherapy after hepatic resection should be tested in prospective randomized trials. Patients with diffuse liver metastases can benefit from locoregional infusion chemotherapy. Symptoms improve in most patients and objective responses are higher than those reported for systemic chemotherapy. Survival benefit with respect to untreated patients, has not yet been demonstrated by prospective randomized studies. Future improvements may be achieved by using new treatment modalities, such as new drug combinations, repeat arterial ischemia, and local tumor destruction. As these types of treatment are still experimental they should be employed only in prospective clinical trials.