Preoperative selection of patients with colorectal cancer liver metastasis for hepatic resection

World Journal of Gastroenterology : WJG
Rafif E MattarMazen Hassanain

Abstract

Surgical resection of colorectal liver metastases (CRLM) has a well-documented improvement in survival. To benefit from this intervention, proper selection of patients who would be adequate surgical candidates becomes vital. A combination of imaging techniques may be utilized in the detection of the lesions. The criteria for resection are continuously evolving; currently, the requirements that need be met to undergo resection of CRLM are: the anticipation of attaining a negative margin (R0 resection), whilst maintaining an adequate functioning future liver remnant. The timing of hepatectomy in regards to resection of the primary remains controversial; before, after, or simultaneously. This depends mainly on the tumor burden and symptoms from the primary tumor. The role of chemotherapy differs according to the resectability of the liver lesion(s); no evidence of improved survival was shown in patients with resectable disease who received preoperative chemotherapy. Presence of extrahepatic disease in itself is no longer considered a reason to preclude patients from resection of their CRLM, providing limited extra-hepatic disease, although this currently is an area of active investigations. In conclusion, we review the indications...Continue Reading

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Citations

Sep 4, 2015·PloS One·Karsten BeiderwellenThomas C Lauenstein
Jul 16, 2010·Clinical Colorectal Cancer·David J Gallagher, Nancy Kemeny
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Jan 1, 2021·Biomedicine & Pharmacotherapy = Biomédecine & Pharmacothérapie·Kailong WangHaiyang Yu
Mar 5, 2021·Clinics and Research in Hepatology and Gastroenterology·Clémence BretonEmilie Soularue

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