M Binnebösel1,2, A Lambertz1, K Dejong1,2, U P Neumann3,4. 1. Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland. 2. Department of Surgery, University Medical Center Maastricht, Maastricht, Niederlande. 3. Klinik für Allgemein‑, Viszeral- und Transplantationschirurgie, Uniklinik der RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland. uneumann@ukaachen.de. 4. Department of Surgery, University Medical Center Maastricht, Maastricht, Niederlande. uneumann@ukaachen.de.
Abstract
BACKGROUND: The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment. MATERIAL AND METHODS: Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given. RESULTS: Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation. CONCLUSION: Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.
BACKGROUND: The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment. MATERIAL AND METHODS: Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given. RESULTS: Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation. CONCLUSION: Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.
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