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Guidelines for the detection and treatment of liver metastases of colorectal cancer

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Abstract

The spread of the surgical treatment for hepatic metastases have been crucial in the improvement of treatment and survival of metastatic colorectal cancer. The early and accurate diagnosis of metastases and the assessment of their size are essential factors to reach the optimal results with this treatment strategy. The precise indication of the surgical technique with or without the previous administration of neoadjuvant chemotherapy is of significant importance for the choice of R0 surgery and the timing of intervention. Although there is an agreement regarding some parameters related to diagnosis techniques and surgical criteria such as the bilobar extension, the size of the remaining liver post-surgical removal and the indication of pre-operatory chemotherapy, it is necessary to consider all these factors to set up standard criteria and optimize the results. In this article we review all these parameters, from disease follow up to detect metastatic dissemination to the basic criteria for use of neoadjuvant chemotherapy, in order to suggest some general recommendations of evidence level II and recommendation grade A.

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References

  1. Wooldridge JE, Shahab N, Doll DC (2003) Introduction: post-treatment surveillance for potentially curable malignancies. Semin Oncol 30:337

    Article  Google Scholar 

  2. Figueredo A, Rumble RB, Maroun J et al (2003) Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer 3:26

    Article  PubMed  Google Scholar 

  3. (2001) ESMO minimum clinical recommendations for diagnosis, adjuvant treatment and follow-up of colon cancer. Ann Oncol 12:1053–1054

  4. (2003) NCCN colon cancer clinical practice guidelines in oncology. J Natl Compr Cancer Network 1:40–53

  5. Desch CE, Benson AB III, Somerfield MR et al (2005) Colorectal cancer surveillance: 2005 Update of an American Society of Clinical Oncology Practice Guideline. J Clin Oncol 23:8512–8519

    Article  PubMed  Google Scholar 

  6. Rodriguez-Moranta F, Saló J, Arcusa A et al (2006) Postoperative surveillance in patients with colorectal cancer who have undergone curative resection: a prospective multicenter randomized controlled trial. J Clin Oncol 24:386–393

    Article  PubMed  Google Scholar 

  7. Valls C, Andía E, Sánchez A et al (2001) Helical CT in liver metastases from colorectal cancer: preoperative detection and assessment of resectability. Radiology 218:55–60

    PubMed  CAS  Google Scholar 

  8. Van Leuveen MS, Noordzij J, Feldberg MAM et al (1996) Focal liver lesions: characterization with triphasic spiral CT. Radiology 201:327–336

    Google Scholar 

  9. Schwartz LH, Gandras EJ, Colangelo SM et al (1999) Prevalence and importance of small hepatic lesions found at CT in patients with cancer. Radiology 210:71–74

    PubMed  CAS  Google Scholar 

  10. Ward J, Naik KS, Guthrie JA et al (1999) Hepatic lesion detection: comparison of MR imaging after the administration of superparamagnetic iron oxide with dual-phase CT by using alternative-free response receiver operating characteristic analysis. Radiology 210:459–466

    PubMed  CAS  Google Scholar 

  11. Mori K, Takahashi N, Hiratsuka M et al (2006) Detection of hepatic metastases using ferucarbotran-enhanced MR imaging: feasibility and diagnostic accuracy of three-dimensional sensitivity-encoding water-excitation multishot echo-planar sequence (3D-SWEEP). J Magn Reson Imaging 24:1110–1116

    Article  PubMed  Google Scholar 

  12. Bipat S, van Leeuwen MS, Comans EF et al (2005) Colorectal liver metastases: CT, MR imaging, and PET for diagnosis-meta-analysis. Radiology 237:123–131

    Article  PubMed  Google Scholar 

  13. Truant S, Huglo D, Hebbar M et al (2005) Prospective evaluation of the impact of [18F]fluoro-2-deoxy-D-glucose positron emission tomography of resectable colorectal liver metastases. Br J Surg 92:362–369

    Article  PubMed  CAS  Google Scholar 

  14. Scheele J, Stang R, Altendorf-Hofmann A (1995) Resection of colorectal liver metastases. World J Surg 19:59–71

    Article  PubMed  CAS  Google Scholar 

  15. Figueras J, Valls C, Rafecas A et al (2001) Resection rate and effect of postoperative chemotherapy on survival after surgery for colorectal liver metastases. Br J Surg 88:980–985

    Article  PubMed  CAS  Google Scholar 

  16. Figueras J, Torras J, Martí-Ragué J et al (2004) Resección quirúrgica de las metastasis hepáticas de carcinoma colorectal. Tratamiento de las recidivas. Cirugía Española 76:292–299

    Google Scholar 

  17. Fong Y, Fortner J, Sun RL et al (1999) Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer. Analysis of 1001 consecutive cases. Ann Surg 230:309–321

    Article  PubMed  CAS  Google Scholar 

  18. Nordlinger B, Guiget M, Vaillant JC et al (1996) Surgical resection of colorectal carcinoma metastases to the liver: a prognostic scoring system to improve case selection. Cancer 771: 1254–1262

    Article  Google Scholar 

  19. Iwatsuki S, Dvorchik I, Madariaga JR et al (1999) Hepatic resection for metastatic colorectal adenocarcinoma. A proposal of a prognostic scoring system. J Am Coll Surg 189:291–299

    Article  PubMed  CAS  Google Scholar 

  20. Adam R, Pascal G, Castaing D et al (2004) Tumor progression while on chemotherapy. A contraindication to liver resection for multiple colorectal metastases. Ann Surg 240:1052–1064

    Article  PubMed  Google Scholar 

  21. Livraghi T, Solbiati L, Meloni F et al (2003) Percutaneous radiofrequency ablation of liver metastases in potential candidates for resection. The “test-of-time” approach. Cancer 97:3027–3035

    Article  PubMed  Google Scholar 

  22. De Baere T, Elias D, Dromain C et al (2000) Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than a year. AJR Am J Roentgenol 175:1619–1625

    PubMed  Google Scholar 

  23. Abdalla EK, Vauthey JN, Ellis LM et al (2004) Recurrence and outcomes following hepatic resection, radiofrequency ablation and combined resection/ablation for colorectal metastases. Ann Surg 239:818–827

    Article  PubMed  Google Scholar 

  24. Adam R, Avisar E, Ariche A et al (2001) Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal. Ann Surg Oncol 8:347–353

    Article  PubMed  CAS  Google Scholar 

  25. Adam R (2003) Chemotherapy and surgery: new perspectives on the treatment of unresectable liver metastases. Ann Oncol 14[Suppl 2]:ii13–ii16

    PubMed  Google Scholar 

  26. Folprecht G, Grothey A, Alberts S et al (2005) Neoadjuvant treatment of unresectable colorectal liver metastases: correlation between tumour response and resection rates. Ann Oncol 16: 1311–1319

    Article  PubMed  CAS  Google Scholar 

  27. Giacchetti S, Itzhaki M, Gruia G et al (1999) Long-term survival of patients with unresectable colorectal cancer liver metastases following infusional chemotherapy with 5-fluorouracil, leucovorin, oxaliplatin and surgery. Ann Oncol 10:663–669

    Article  PubMed  CAS  Google Scholar 

  28. Alberts SR, Horvath WL, Sternfeld WC et al (2005) Oxaliplatin, 5-fluorouracil, and leucovorin (FOLFOX4) for patients with unresectable liver-only metastases from colorectal cancer: a North Central Cancer Treatment Group (NCCTG) phase II study. J Clin Oncol 23:9243–9249

    Article  PubMed  CAS  Google Scholar 

  29. Pozzo C, Basso M, Cassano A et al (2004) Neoadjuvant treatment of unresectable liver disease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients. Ann Oncol 15:933–939

    Article  PubMed  CAS  Google Scholar 

  30. Abad A, Massuti B, Antón A et al (2007) Colorectal cancer metastasis resectability after treatment with the combination of oxaliplatin, irinotecan and 5-fluorouracil. Final results of a phase II study. Acta Oncologica. 2007. In press

  31. De Gramont A, Figer A, Seymur M et al (2000) Leucovorin and fluoracil with or without oxaliplatin as fist line treatment for advanced colorectal cancer. J Clin Oncol 18:2938–2947

    PubMed  Google Scholar 

  32. Tournigand C, Louvet C, Quinaux E et al (2001) FOLFIRI followed by FOLFOX versus FOLFOX followed by FOLFIRI in metastatic colorectal cancer (MCRC): final results of a Phase III study. Proc Am Soc Clin Oncol 20:124a (abst 494)

    Google Scholar 

  33. Dçiaz Rubio E, Tabernero J, Van Cutsem E et al (2005) Cetuximab in combination with oxaliplatin/5-fluorouracil/folinic acid (FOLFOX-4) in the first-line treatment of patients with epidermal growth factor receptor expressing metastatic colorectal cancer: an international phase II study. J Clin Oncol 23[suppl; abstr 3535]:254

    Google Scholar 

  34. Vauthey JN, Pawlik TM, Ribero D (2006) Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol 24:2065–2072

    Article  PubMed  CAS  Google Scholar 

  35. Ellis LM, Curley SA, Grothey A (2005) Surgical resection after downsizing of colorectal liver metastasis in the era of bevacizumab. J Clin Oncol 23:4853–4855

    Article  PubMed  CAS  Google Scholar 

  36. Kemeny N (2006) Management of liver metastases from colorectal cancer. Oncology (Huntingt) 20:1161–1176, 1179

    Google Scholar 

  37. Portier G, Elias D, Bouche O et al (2006) Multicenter randomized trial of adjuvant Fluorouracil and folinic acid compared with surgery alone after resection of colorectal liver metastases: FFCD ACHBTH AURC 9002 trial. J Clin Oncol 24:4976–4982

    Article  PubMed  CAS  Google Scholar 

  38. Sperti E, Faggiuolo R, Gerbino A et al (2006) Outcome of metastatic colorectal cancer: analysis of a consecutive series of 229 patients. The impact of a multidisciplinary approach. Dis Colon Rectum 49:1596–1601

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Medical Oncology Service, University Hospital Germans Trias i Pujol Catalan Institute of Oncology (ICO), ES-08916, Badalona, Barcelona, Spain

    A. Abad

  2. Department of Surgery, Hospital Josep Trueta, Girona, Spain

    J. Figueras

  3. Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain

    C. Valls

  4. Medical Oncology Service, Hospital General Universitario, Elche, Alicante, Spain

    A. Carrato

  5. Department of Surgery, Clínica Universitaria de Navarra, Pamplona, Spain

    F. Pardo

  6. Medical Oncology Service, Hospital Clínico San Carlos, Madrid, Spain

    E. Díaz-Rubio

  7. Medical Oncology Service, Hospital Universitario Reina Sofía, Córdoba, Spain

    E. Aranda

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  1. A. Abad
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  2. J. Figueras
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  3. C. Valls
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  4. A. Carrato
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  7. E. Aranda
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Correspondence to A. Abad.

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Abad, A., Figueras, J., Valls, C. et al. Guidelines for the detection and treatment of liver metastases of colorectal cancer. Clin Transl Oncol 9, 723–730 (2007). https://doi.org/10.1007/s12094-007-0129-x

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  • DOI: https://doi.org/10.1007/s12094-007-0129-x

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