Update on the optimal management of patients with colorectal liver metastases

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Patients with colorectal liver metastases represent a distinct subset of metastatic colorectal cancer. Optimal management requires a multidisciplinary approach, local and systemic. Curative hepatic surgery is standard for resectable cases, but unfortunately, the majority of patients are not initially resectable due to the size, location, and/or extent of disease, inadequate remnant liver volume, or comorbidities. Other local approaches may be complementary (such as portal vein embolization) or alternative (such as ablation, hepatic arterial infusion, selective internal radiation therapy, and stereotactic body radiotherapy) to surgery. Systemic therapy can downsize disease, allowing surgical resection and, potentially, long-term survival, but it must be balanced against the potential for hepatotoxicity. Current standard approaches including cytotoxics and biologics, such as bevacizumab and particularly anti-epidermal growth factor receptor therapy, improve response rates and may enhance downsizing and resection rates. Optimization of local therapies and systemic conversion strategies via controlled, randomized trials is still a pending question.

Original languageEnglish (US)
Pages (from-to)59-70
Number of pages12
JournalCritical Reviews in Oncology/Hematology
Volume84
Issue number1
DOIs
StatePublished - Oct 2012

Fingerprint

Neoplasm Metastasis
Liver
Radiosurgery
Portal Vein
Biological Products
Epidermal Growth Factor Receptor
Comorbidity
Colorectal Neoplasms
Radiotherapy
Therapeutics
Randomized Controlled Trials
Survival
Bevacizumab

Keywords

  • Ablation
  • Bevacizumab
  • Cetuximab
  • Colorectal cancer liver metastases
  • Hepatic arterial infusion
  • Portal vein embolization
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Geriatrics and Gerontology

Cite this

Update on the optimal management of patients with colorectal liver metastases. / Alberts, Steven Robert.

In: Critical Reviews in Oncology/Hematology, Vol. 84, No. 1, 10.2012, p. 59-70.

Research output: Contribution to journalArticle

@article{442c9924d81d4762ac6383ae89fbc2d9,
title = "Update on the optimal management of patients with colorectal liver metastases",
abstract = "Patients with colorectal liver metastases represent a distinct subset of metastatic colorectal cancer. Optimal management requires a multidisciplinary approach, local and systemic. Curative hepatic surgery is standard for resectable cases, but unfortunately, the majority of patients are not initially resectable due to the size, location, and/or extent of disease, inadequate remnant liver volume, or comorbidities. Other local approaches may be complementary (such as portal vein embolization) or alternative (such as ablation, hepatic arterial infusion, selective internal radiation therapy, and stereotactic body radiotherapy) to surgery. Systemic therapy can downsize disease, allowing surgical resection and, potentially, long-term survival, but it must be balanced against the potential for hepatotoxicity. Current standard approaches including cytotoxics and biologics, such as bevacizumab and particularly anti-epidermal growth factor receptor therapy, improve response rates and may enhance downsizing and resection rates. Optimization of local therapies and systemic conversion strategies via controlled, randomized trials is still a pending question.",
keywords = "Ablation, Bevacizumab, Cetuximab, Colorectal cancer liver metastases, Hepatic arterial infusion, Portal vein embolization, Stereotactic body radiotherapy",
author = "Alberts, {Steven Robert}",
year = "2012",
month = "10",
doi = "10.1016/j.critrevonc.2012.02.007",
language = "English (US)",
volume = "84",
pages = "59--70",
journal = "Critical Reviews in Oncology/Hematology",
issn = "1040-8428",
publisher = "Elsevier Ireland Ltd",
number = "1",

}

TY - JOUR

T1 - Update on the optimal management of patients with colorectal liver metastases

AU - Alberts, Steven Robert

PY - 2012/10

Y1 - 2012/10

N2 - Patients with colorectal liver metastases represent a distinct subset of metastatic colorectal cancer. Optimal management requires a multidisciplinary approach, local and systemic. Curative hepatic surgery is standard for resectable cases, but unfortunately, the majority of patients are not initially resectable due to the size, location, and/or extent of disease, inadequate remnant liver volume, or comorbidities. Other local approaches may be complementary (such as portal vein embolization) or alternative (such as ablation, hepatic arterial infusion, selective internal radiation therapy, and stereotactic body radiotherapy) to surgery. Systemic therapy can downsize disease, allowing surgical resection and, potentially, long-term survival, but it must be balanced against the potential for hepatotoxicity. Current standard approaches including cytotoxics and biologics, such as bevacizumab and particularly anti-epidermal growth factor receptor therapy, improve response rates and may enhance downsizing and resection rates. Optimization of local therapies and systemic conversion strategies via controlled, randomized trials is still a pending question.

AB - Patients with colorectal liver metastases represent a distinct subset of metastatic colorectal cancer. Optimal management requires a multidisciplinary approach, local and systemic. Curative hepatic surgery is standard for resectable cases, but unfortunately, the majority of patients are not initially resectable due to the size, location, and/or extent of disease, inadequate remnant liver volume, or comorbidities. Other local approaches may be complementary (such as portal vein embolization) or alternative (such as ablation, hepatic arterial infusion, selective internal radiation therapy, and stereotactic body radiotherapy) to surgery. Systemic therapy can downsize disease, allowing surgical resection and, potentially, long-term survival, but it must be balanced against the potential for hepatotoxicity. Current standard approaches including cytotoxics and biologics, such as bevacizumab and particularly anti-epidermal growth factor receptor therapy, improve response rates and may enhance downsizing and resection rates. Optimization of local therapies and systemic conversion strategies via controlled, randomized trials is still a pending question.

KW - Ablation

KW - Bevacizumab

KW - Cetuximab

KW - Colorectal cancer liver metastases

KW - Hepatic arterial infusion

KW - Portal vein embolization

KW - Stereotactic body radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=84866487024&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84866487024&partnerID=8YFLogxK

U2 - 10.1016/j.critrevonc.2012.02.007

DO - 10.1016/j.critrevonc.2012.02.007

M3 - Article

VL - 84

SP - 59

EP - 70

JO - Critical Reviews in Oncology/Hematology

JF - Critical Reviews in Oncology/Hematology

SN - 1040-8428

IS - 1

ER -