Multisciplinary management of patients with liver metastasis from colorectal cancer

被引:68
作者
De Greef, Kathleen [1 ]
Rolfo, Christian [2 ,3 ]
Russo, Antonio [4 ]
Chapelle, Thiery [1 ]
Bronte, Giuseppe [4 ]
Passiglia, Francesco [2 ,3 ,4 ]
Coelho, Andreia [2 ,3 ,5 ]
Papadimitriou, Konstantinos [3 ,6 ]
Peeters, Marc [3 ,6 ]
机构
[1] Univ Antwerp Hosp, Hepatobiliary Transplant & Endocrine Surg Dept, B-2650 Edegem, Belgium
[2] Univ Antwerp Hosp, Phase Early Clin Trials Unit 1, Dept Oncol, Wilrijkstr 10, B-2650 Edegem, Belgium
[3] Univ Antwerp Hosp, Multidisciplinary Oncol Ctr Antwerp, B-2650 Edegem, Belgium
[4] Univ Palermo, Sect Med Oncol, Dept Surg Oncol & Oral Sci, I-90133 Palermo, Italy
[5] Ctr Hosp Tras Os Montes & Alto Douro, Dept Oncol, P-5000508 Vila Real, Portugal
[6] Univ Antwerp Hosp, Dept Oncol, B-2650 Edegem, Belgium
关键词
Liver metastases; Colorectal cancer; Liver resection; Multidisciplinary team; Chemotherapy; PHASE-III TRIAL; CHEMOTHERAPY-ASSOCIATED HEPATOTOXICITY; RANDOMIZED CONTROLLED-TRIAL; LONG-TERM SURVIVAL; HEPATIC RESECTION; 1ST-LINE TREATMENT; ANATOMIC RESECTION; HEPATOCELLULAR-CARCINOMA; PREOPERATIVE ASSESSMENT; NEOADJUVANT CHEMOTHERAPY;
D O I
10.3748/wjg.v22.i32.7215
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Colorectal cancer (CRC) is one of the leading causes of cancer-related death. Surgery, radiotherapy and chemotherapy have been till now the main therapeutic strategies for disease control and improvement of the overall survival. Twenty-five per cent (25%) of CRC patients have clinically detectable liver metastases at the initial diagnosis and approximately 50% develop liver metastases during their disease course. Twenty-thirty per cent (20%-30%) are CRC patients with metastases confined to the liver. Some years ago various studies showed a curative potential for liver metastases resection. For this reason some authors proposed the conversion of unresectable liver metastases to resectable to achieve cure. Since those results were published, a lot of regimens have been studied for resectability potential. Better results could be obtained by the combination of chemotherapy with targeted drugs, such as anti-VEGF and anti-EGFR monoclonal antibodies. However an accurate selection for patients to treat with these regimens and to operate for liver metastases is mandatory to reduce the risk of complications. A multidisciplinary team approach represents the best way for a proper patient management. The team needs to include surgeons, oncologists, diagnostic and interventional radiologists with expertise in hepatobiliary disease, molecular pathologists, and clinical nurse specialists. This review summarizes the most important findings on surgery and systemic treatment of CRC-related liver metastases.
引用
收藏
页码:7215 / 7225
页数:11
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