Surgical treatment of hepatic colorectal metastasis: Evolving role in the setting of improving systemic therapies and ablative treatments in the 21st century Journal Article
| Authors: | Ito, K.; Govindarajan, A.; Ito, H.; Fong, Y. |
| Article Title: | Surgical treatment of hepatic colorectal metastasis: Evolving role in the setting of improving systemic therapies and ablative treatments in the 21st century |
| Abstract: | Liver resection has clearly been established as the standard treatment for resectable colorectal liver metastases. This article will review the expanding role for hepatectomy in this disease. Faster and safer hepatectomies are allowing combined resections of the primary cancer and synchronous hepatic metastases. Effective neoadjuvant chemotherapy, as well as increasing data demonstrating effectiveness and safety of combined hepatectomy and ablative therapies, have further expanded the pool of patients now selected for resection. The end result is that increasing numbers of patients are undergoing acceptably aggressive surgical therapies with extension of life and possible cure. Successful multimodality therapies are also now allowing for long-term survival even in patients not cured of cancer. The prolonged survival of most patients treated by hepatectomy has allowed a long-term analysis of the patterns of recurrence, which emphasize the importance of controlling liver disease for prolongation of life. These improvements in treatments for hepatic metastases have come with a precipitous escalation of the costs of care. This will likely require that future clinical trials and algorithms of care not only be based on cancer outcome data but also on value analysis of treatment and follow-up regimens. Copyright © 2010 by Lippincott Williams & Wilkins. |
| Keywords: | cancer survival; treatment outcome; primary tumor; overall survival; review; cancer recurrence; bevacizumab; fluorouracil; cancer risk; multimodality cancer therapy; systemic therapy; treatment duration; liver neoplasms; cancer adjuvant therapy; chemotherapy; positron emission tomography; follow up; colorectal cancer; animals; bleeding; cetuximab; time factors; irinotecan; colorectal neoplasms; survival time; liver metastasis; hospitalization; algorithm; folinic acid; adjuvant chemotherapy; fluorodeoxyglucose f 18; colon resection; liver resection; disease free interval; liver disease; therapy effect; oxaliplatin; cryoablation; radiofrequency ablation; floxuridine; cost; hepatic colorectal metastasis; catheter ablation; neoadjuvant; microwave radiation; surgical outcome; adjuvant; microwave ablation; recurrence pattern; cell synchronization; life extension |
| Journal Title: | The Cancer Journal |
| Volume: | 16 |
| Issue: | 2 |
| ISSN: | 1528-9117 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2010-03-01 |
| Start Page: | 103 |
| End Page: | 110 |
| Language: | English |
| DOI: | 10.1097/PPO.0b013e3181d7e8e5 |
| PUBMED: | 20404606 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: CAJOC" - "Source: Scopus" |
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