Interdisciplinary Treatment of Patients with Colorectal Liver Metastases

Interdisciplinary Treatment of Patients with Colorectal Liver Metastases At diagnosis, about 20% of the patients with colorectal carcinoma show synchronous liver metastases. Treatment of these patients is an interdisciplinary challenge. Due to the improvement of diagnostic and therapeutic procedures, there has been a significant increase in long-term survival. Even in the palliative setting, patients benefit from novel multimodal treatment approaches. Initially, the resectability of primary tumors as well as metastases needs to be assessed by interdisciplinary groups or tumor boards, in which liver surgeons, oncologists, radiologists, radiation oncologists, pathologists and nuclear medicine physicians are involved. Patients with an initially nonresectable tumor disease may become resectable after intensified neoadjuvant treatment. In the palliative setting, the aim is to prolong survival and increase quality of life. Systemic treatment with chemotherapy and biologicals provides incremental improvement in median overall survival. In addition, various other regional and locally destructive treatment options may be beneficial for patients with liver metastases of colorectal carcinoma, either combined with systemic treatment or alone. The individual treatment concepts depend on the experience of the center and should be regularly discussed by interdisciplinary teams.