Therapy of colorectal carcinoma liver metastases

Czech version

Authors: J. Pudil ¹; S. Batko ²; K. Menclová ¹; M. Rousek ¹; M. Ryska ¹
Authors‘ workplace: Chirurgická klinika 2. LF UK a ÚVN, Praha ¹; Onkologická klinika 2. LF UK a FN Motol, Praha ²
Published in: Gastroent Hepatol 2018; 72(5): 391-396
Category: Gastrointestinal Oncology: Review Article
doi: https://doi.org/10.14735/amgh2018391

Overview

Introduction:

Sixty percent of patients with colorectal carcinoma develop liver metastases (LMKRK). Surgical treatment is the most frequent treatment modality and has a 5-year survival rate of near 50%. However, less than 20% of patients with LMKRK undergo lLiver resection. Systematic treatment may allow resection of primary unresectable patients or may significantly prolong life expectancy. The optimal treatment strategy is decided by a multidisciplinary team. Surgical treatment: We defined the technical and oncological aspects of resectability and evaluated the incidence of liver remnants, eventually possibilities of its enlargement. We also mention the different surgical treatment methods including type of resection method, multi-step approach, liver first approach, and radiofrequency ablation. Systemic treatment: Developes rapidly, current options for chemotherapy and biological treatment are mentioned. Also, the indications for perioperative treatment in patients with resectable disease are mentioned. Conversion therapy in patients with primary unresecable disease is discussed. Conclusion: Despite developments in systematic therapy, liver resection is still the best curative method for LMKRK treatment. Close cooperation with liver surgeon and a clinical oncologist within a multidisciplinary team is a crucial condition for increasing resectability in patients with LMKRK.

Key words:

colorectal cancer – liver metastases – liver resection – systhemic therapy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

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