Presurgical chemotherapy in patients being considered for liver resection Journal Article
| Author: | Kemeny, N. |
| Article Title: | Presurgical chemotherapy in patients being considered for liver resection |
| Abstract: | The liver is a frequent site of metastatic disease for colorectal cancer patients. Approximately 15% of patients have liver metastases at diagnosis and another 50% develop metastatic disease to the liver over the course of their disease. Advances in systemic chemotherapy and surgical techniques for hepatic resection have led to longer survival times for these patients. There is no doubt that unresectable patients benefit from systemic chemotherapy. For patients who have resectable disease, the timing of chemotherapy is still not clear. This review addresses the pros and cons of presurgical chemotherapy. The benefits of preoperative chemotherapy include decreasing tumor size, controlling micrometastatic disease, assessing activity of chemotherapy, improving chemotherapy tolerance, and perhaps allowing some prediction of the success of liver resection. The risks for presurgical chemotherapy include liver toxicity, the risk for progression or growth of new sites, secondary splenomegaly, selection of resistant clones, and the possibility of leaving behind active tumor that is no longer seen because of a complete radiographic response. The challenge for the future is to develop a multidisciplinary team approach that can design the best treatment plan for patients with liver metastases. ©AlphaMed Press. |
| Keywords: | cancer chemotherapy; cancer survival; treatment outcome; treatment response; survival analysis; surgical technique; clinical trial; review; bevacizumab; cisplatin; doxorubicin; fluorouracil; cancer growth; cancer risk; disease classification; drug potentiation; patient selection; liver neoplasms; adjuvant therapy; cancer patient; preoperative care; neoadjuvant therapy; antineoplastic agent; colorectal cancer; liver toxicity; tumor volume; antineoplastic combined chemotherapy protocols; morbidity; tumor markers, biological; combination chemotherapy; dexamethasone; deep vein thrombosis; drug effect; irinotecan; lung embolism; postoperative complication; colorectal neoplasms; liver metastasis; add on therapy; acetylsalicylic acid; cyclooxygenase 2 inhibitor; folinic acid; splenomegaly; warfarin; neoplasm metastasis; liver resection; neoadjuvant chemotherapy; heart arrhythmia; oxaliplatin; floxuridine; computer program; wound infection; organoplatinum compounds; leucovorin; drug tolerance; steatosis; abscess; liver necrosis; levamisole; hepatotoxicity from chemotherapy; steatohepatitis |
| Journal Title: | The Oncologist |
| Volume: | 12 |
| Issue: | 7 |
| ISSN: | 1083-7159 |
| Publisher: | Oxford University Press |
| Date Published: | 2007-07-01 |
| Start Page: | 825 |
| End Page: | 839 |
| Language: | English |
| DOI: | 10.1634/theoncologist.12-7-825 |
| PUBMED: | 17673614 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 30" - "Export Date: 17 November 2011" - "CODEN: OCOLF" - "Source: Scopus" |
