[Surgical treatment of liver metastases from colorectal cancer].

Abstract

BACKGROUND:

The liver is the most common location for metastases from colorectal cancer. Current treatment options (i.e. neo-adjuvant chemotherapy, pre-operative portal vein embolization), IMPROVED OPERATIVE TECHNIQUES: and combinations of modalities and have rendered more patients eligible for liver surgery.

MATERIAL AND METHODS:

Literature from 1996 to July 2007 was retrieved from Pubmed using the search terms "liver metastases", "liver resection", "colorectal cancer", "randomized controlled trial", "systematic review" and "meta-analysis".

RESULTS:

No randomized controlled trials were identified that compared liver resection with non-surgical treatment of these patients. Except for a few systematic review articles, the scientific basis for resection of liver metastases from colorectal cancer consists mainly of retrospective studies from single institutions. Median survival for patients with colorectal liver metastases is about 20 months; a five-year survival of 30-50% is reported in resected patients. Patients with non-resectable disease rarely survive for five years. 30-40% of the resected patients have post-operative complications (mostly minor) and postoperative mortality is 3-5%.

INTERPRETATION:

Surgical treatment of liver metastases is established practice. Patients with colorectal liver metastases should be referred to a multidisciplinary team for appropriate evaluation. Neoadjuvant treatment and multimodal approaches may increase the proportion of patients with resectable liver metastases, and better preoperative imaging may help to more carefully select patients who can benefit from this treatment.

• Authors: Jon Arne Søreide, Kristinn Eiriksson, Oddvar Sandvik, Asgaut Viste, Arild Horn, Gjermund Johnsen, Jon Erik Grønbech
• Journal: Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke (Tidsskr Nor Laegeforen) Vol. 128 Issue 1 Pg. 50-3 (Jan 03 2008) ISSN: 0807-7096 [Electronic] Norway
• Vernacular Title: Kirurgisk behandling av levermetastaser fra kolorektal kreft.
• PMID: 18183058 (Publication Type: Journal Article, Review, Systematic Review)

Topics

• Colorectal Neoplasms (pathology)
• Humans
• Liver (pathology)
• Liver Neoplasms (mortality, pathology, secondary, surgery)
• Magnetic Resonance Imaging
• Patient Care Planning
• Patient Care Team
• Prognosis
• Tomography, X-Ray Computed
• Treatment Outcome