Colorectal liver metastases surgery – the present and the perspectives
Authors:
V. Třeška 1; T. Skalický 1; J. Ferda 2
; J. Fínek 3; V. Liška 1
Authors place of work:
Chirurgická klinika FN a LFUK v Plzni, přednosta: Prof. MUDr. V. Třeška, DrSc.
1; Radiodiagnostická klinika FN a LFUK v Plzni, přednosta: prof. MUDr. B. Kreuzberg, CSc.
2; Onkologická a radioterapeutická klinika FN a LFUK v Plzni, přednosta: prof. MUDr. J. Fínek, PhD.
3
Published in the journal:
Rozhl. Chir., 2014, roč. 93, č. 12, s. 568-571.
Category:
Review
Summary
The incidence of colorectal liver metastases (CLM) in the fourth stage of colorectal carcinoma is 80%, liver parenchyma only being impaired in 40% of patients. Liver resection is the “gold standard” of treatment with long-term overall survival. However, only 20−25% of CLM are primarily resectable. Many staged procedures exist for increasing secondary CLM resectability – modern oncologic therapy, portal vein embolization, stem cells application, ALPPS (associating liver partition and portal vein ligation for staged hepatectomy), sequential liver procedures, combined resections with thermoablation procedures. Perioperative oncological therapy in primary resectable CLM is currently recommended. The patients’ prognosis depends on the biological CLM activity, which is evaluated according to several serum or histopathological markers. Resectable extrahepatic metastases are no more a contraindication for liver resection. One-stage resection of primary tumour and CLM is recommended in cases where one procedure is simple and short. Liver first procedure can be used in patients with the risk of non-resectability of advanced CLM after the treatment of primary colorectal cancer. Up to 55−60% of patients will develop recurrent CLM which are resectable in many cases, or thermoablation methods can be used.
Key words:
liver surgery − colorectal metastases
Zdroje
1. Frankel TL, D´Angelica MI. Hepatic resection for colorectal metastases. JSO 2014;109:2−7.
2. Ryska M, Pantoflicek J, Dusek L. Surgery for liver metastases of colorectal etiology in Czech Republic: current national survey. Rozhl Chir 2010;89:100−8.
3. Jones RP, Stattner S, Sutton P, Dunne DF, McWhirter D, et al. Controversies in the oncosurgical management of liver limited stage IV colorectal cancer. J Surg Oncol 2014;23:53−60.
4. Akgul O, Centinkaya E, Ersoz S, Tez M. Role of surgery in colorectal liver metastases. World J Gastroenterol 2014;20:6113−22.
5. Spolverato G, Ejaz A, Azad N, Pawlik TM. Surgery for colorectal liver metastases: The evolution of determining prognosis. Word J Gastrointest Oncol 2013;5:207−21.
6. Adams RB, Aloia TA, Loyer E, Pawlik TM, Taouli B, et al. Selection for hepatic resection of colorectal liver metastases: expert consensus statement. HPB 2013;15:91−103.
7. Hwang M, Jayakrishnan TT, Green DE, George B, Thomas JP, et al. Systematic review of outcomes of patients undergoing resection for colorectal liver metastases in the setting of extra hepatic disease. European Journal of Cancer 2014;50:1747−57.
8. Tranchart H, Chirica M, Faron M, Balladur P, Lefevre LB, et al. Prognostic impact of positive surgical margins after resection of colorectal cancer liver metastases: Reappraisal in the era of modern chemotherapy. World j Surg 2013;37:2647−54.
9. Bokemeyer C, Van Cutsem E, Rougier P, Ciardiello F, Heeger S, et al. Addition of cetuximab to chemotherapy as first-line treatment for KRAS wild-type metastatic colorectal cancer: pooled analysis of the CRYSTAL and OPUS randomised clinical trials. Eur J Cancer 2012;48:1466−75.
10. Petruzelka L, Georgiev P. Neoadjuvant and adjuvant therapy in the treatment of colorectal carcinoma. Rozhl Chir 2012;91:53−8.
11. Treska V, Duras P, Mirka H, Skalicky T, Vycital O, et al. Chemoembolization with Drug Eluting Beads (TACE DEB) in patients with primary unresectable hepatocellular carcinoma (HCC). Rozhl Chir 2014;93:63−69.
12. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, et al. Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol 2013;14:1208−15.
13. Truant S, Sequier C, Leteurtre E, Boleslawski E, Elamrani M, et al. Tumour biology of colorectal liver metastasis is a more important factor in survival than surgical margin clearance in the era of modern chemotherapy regimens. HPB 2014 (Epub ahead of print).
14. Legou F, Chiaradia M, Baranes l, Pigneur F, Zegai B, et al. Imaging strategies before beginning treatment of colorectal liver metastases. Diagnostic and Interventional Imaging 2014;95:505−12.
15. Choti MA. Liver-directed treatments for metastatic colorectal cancer. Current Treatment Options in Oncology 2014 (Epub ahead of print).
16. Worni M, Shah KN, Clary BM. Colorectal cancer with potentially resectable hepatic metastases: optimizing treatment. Curr Oncol Rep 2014;16:407−12.
17. Feng Q, Wei Y, Zhu D, Ye L, Lin Q, el al. Timing of hepatectomy for resectable synchronous colorectal liver metastases: for whom simultaneous resection is more suitable – a meta-analysis. PLoS One 2014;9:1043−48.
18. Dimitroulis D, Tsaparas P, Valsami S, Mantas D, Spartalis E, et al. Indications, limitations and maneuvers to enable extended hepatectomy: Current trends. WJG 2014;20:7887−93.
19. Asencio JM, Sabrido JLG, Olmedilla L. How to expand the safe limits in hepatic resections? Hepatobiliary Pancreat Sci 2014;21:399−404.
20. Sindoh J, Tzeng CWD, Aloia TA, Curley SA, Zimmitti G, et al. Portal vein embolization improves rate of resection of extensive colorectal liver metastases without worsening survival. BJS 2013;100:1777−83.
21. Treska V, Koza V, Lysak D, Slauf F, Mirka H, et al. Portal vein embolization and application of autologous stem cells in patients with primary unresectable liver tumours. Bratisl Lek Listy 2013;114:389−93.
22. Peteja M, Martínek L, Mazur M, Vávra P, Zonča P, et al. A new strategy in the surgical treatment of multiple liver tumors - ALPPS. Rozhl Chir 2014;93:301−6.
23. Saiura A, Yamamoto J, Koga R, Takahashi Y, Takahashi M, et al. Favorable outcome after repeat resection for colorectal liver metastases. Ann Surg Oncol 2014 (Epub ahead of print).
24. Gallinger S, Biagi JJ, Fletcher GG, Nhan C, Ruo L, et al. Liver resection for colorectal cancer metastases. Curr Oncol 2013;209:255−65.
25. Subrt Z, Ferko A, Cecka F, Jon B. Current trends of surgical therapy of focal liver and pancreatic lesions. Vnitr Lek 2011;57:356−63.
Štítky
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