Update on the optimal management of patients with colorectal liver metastases

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations

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 1 2012

Keywords

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

ASJC Scopus subject areas

  • Hematology
  • Oncology

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