Adjuvant Therapy After Liver Resection for Colorectal Cancer Metastasis: What is the Evidence?
First Online: 14 April 2011 DOI:
10.1007/s11888-011-0096-z Cite this article as: Arnold, D. & Stein, A. Curr Colorectal Cancer Rep (2011) 7: 180. doi:10.1007/s11888-011-0096-z Abstract
Synchronous or metachronous liver metastases of colorectal origin (colorectal liver metastases, CLM), although being the expression of systemic disease, allow a curative approach for about 25% to 35% of patients. Patients presenting with CLM should receive a multimodal management in order to increase the number of patients undergoing R0 surgery and to decrease the rate of recurrence. Current data do not allow to recommend the use of locally applied chemotherapy using hepatic artery infusion after resection of CLM. Postoperative and/or preoperative systemic chemotherapy shows a trend toward a benefit regarding progression-free and overall survival, without increasing postoperative complication rates. However, all available trials failed to show a statistical significance, so that a “formal” treatment standard is not accepted and recommendations differ between no treatment and a 5-FU/oxaliplatin combination to be considered as standard of care. Future research will help in defining treatment regimens and patients selection criteria to obtain a better approach in this setting.
Keywords Colorectal cancer Liver metastases Adjuvant Postoperative Perioperative Chemotherapy Hepatic intraarterial infusion (HAI) References Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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