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Management of hepatic metastasis from colorectal cancers: an update
Author(s) -
Sharma Sharad,
Camci Cemalettin,
Jabbour Nicolas
Publication year - 2008
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-008-1350-x
Subject(s) - medicine , contraindication , colorectal cancer , portal vein embolization , resection , metastasis , multimodal therapy , chemotherapy , stage (stratigraphy) , disease , hepatectomy , surgical oncology , surgery , oncology , cancer , pathology , paleontology , alternative medicine , biology
Approximately 50%–60% of patients with colorectal cancers will develop liver lesions in their life span. Despite the potential of surgical resection to provide long‐term survival in this subset of patients, only 15%–20% are found to be resectable. The introduction of new neoadjuvant chemotherapeutic agents and the expanding criteria of resection have enhanced the overall 5‐year survival from 30% to 60% in the past decade. The use of technical innovations such as staged resection; portal vein embolization, and repeat resection have allowed higher resection rates in patients with bilobar disease. Extrahepatic primary and liver‐exclusive recurrent disease no longer represent an absolute contraindication to resection. The role of regional therapy using hepatic arterial infusion is being redefined for liver‐exclusive unresectable disease. Adjuvant chemotherapy in combination with regional therapies is being looked at from fresh perspectives. Ablative approaches have gained a firm role both as an adjunct to surgical resection and in the management of patients who are not surgical candidates. Overall, the management of hepatic metastasis from colorectal cancers requires a multimodal approach.