Terence C Chua1, David L Morris. 1. Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery, St George Hospital and St George Clinical School, University of New South Wales, Kogarah, Sydney, NSW, 2217, Australia. terence.chua@unsw.edu.au
Abstract
BACKGROUND: Emerging data suggest that in the current era of modern systemic therapies, resection of colorectal liver metastases with concomitant extrahepatic disease may be a curative option in selected patients. METHODS: A commentary of several key recent papers including an international multi-institutional registry study may provide directions in the future management of this disease entity. RESULTS: The premise of selecting patients for a surgical approach to resect colorectal liver metastases and concomitant extrahepatic disease should be individualized. Incorporation of key prognostic factors that include the site of extrahepatic disease, the ability to undertake a complete resection, disease responding to chemotherapy, and an assessment of tumor biology through examining an individual's disease history may guide the selection of suitable patients for this therapeutic pursuit. A 5-year survival of 30% may be realized in well-selected patients. CONCLUSION: Concomitant extrahepatic disease in patients with colorectal liver metastases should not be a contraindication to resection of colorectal cancer metastases.
BACKGROUND: Emerging data suggest that in the current era of modern systemic therapies, resection of colorectal liver metastases with concomitant extrahepatic disease may be a curative option in selected patients. METHODS: A commentary of several key recent papers including an international multi-institutional registry study may provide directions in the future management of this disease entity. RESULTS: The premise of selecting patients for a surgical approach to resect colorectal liver metastases and concomitant extrahepatic disease should be individualized. Incorporation of key prognostic factors that include the site of extrahepatic disease, the ability to undertake a complete resection, disease responding to chemotherapy, and an assessment of tumor biology through examining an individual's disease history may guide the selection of suitable patients for this therapeutic pursuit. A 5-year survival of 30% may be realized in well-selected patients. CONCLUSION: Concomitant extrahepatic disease in patients with colorectal liver metastases should not be a contraindication to resection of colorectal cancer metastases.
Authors: Carlo Pulitanò; Martin Bodingbauer; Luca Aldrighetti; Mechteld C de Jong; Federico Castillo; Richard D Schulick; Rowan W Parks; Michael A Choti; Stephen J Wigmore; Thomas Gruenberger; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2010-12-07 Impact factor: 5.344
Authors: René Adam; Robbert J de Haas; Dennis A Wicherts; Thomas A Aloia; Valérie Delvart; Daniel Azoulay; Henri Bismuth; Denis Castaing Journal: J Clin Oncol Date: 2008-08-01 Impact factor: 44.544
Authors: Gunnar Folprecht; Thomas Gruenberger; Wolf O Bechstein; Hans-Rudolf Raab; Florian Lordick; Jörg T Hartmann; Hauke Lang; Andrea Frilling; Jan Stoehlmacher; Jürgen Weitz; Ralf Konopke; Christian Stroszczynski; Torsten Liersch; Detlev Ockert; Thomas Herrmann; Eray Goekkurt; Fabio Parisi; Claus-Henning Köhne Journal: Lancet Oncol Date: 2009-11-26 Impact factor: 41.316
Authors: Perry Shen; Kurt Thai; John H Stewart; Russell Howerton; Brian W Loggie; Gregory B Russell; Edward A Levine Journal: Ann Surg Oncol Date: 2008-09-11 Impact factor: 5.344
Authors: Christophe Laurent; Antonio Sa Cunha; Eric Rullier; Denis Smith; Anne Rullier; Jean Saric Journal: J Am Coll Surg Date: 2004-06 Impact factor: 6.113
Authors: Timothy M Pawlik; Lia Assumpcao; Josephina A Vossen; Manon Buijs; Ana L Gleisner; Richard D Schulick; Michael A Choti Journal: Ann Surg Oncol Date: 2008-11-20 Impact factor: 5.344