Skip to main content

When Should Patients with Liver Metastases from Colorectal Cancer Receive Chemotherapy?

  • Chapter
  • First Online:
Difficult Decisions in Hepatobiliary and Pancreatic Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

  • 1128 Accesses

Abstract

Advances in hepatic resection techniques and cytotoxic therapy over the last 30 years have led to vast improvements in outcomes after hepatic resection in patients with colorectal liver metastases (CLM). Nonetheless, the optimal sequence of therapy for CLM remains a significant clinical challenge. This chapter will summarize the evidence-based literature that pertains to the timing of chemotherapy in relation to surgery for CLM in the absence of extra-hepatic metastases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Dimick JB, Cowan Jr JA, Knol JA, Upchurch Jr GR. Hepatic resection in the United States: indications, outcomes, and hospital procedural volumes from a nationally representative database. Arch Surg. 2003;138(2):185–91.

    Article  PubMed  Google Scholar 

  2. Wilson SM, Adson MA. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg. 1976;111(4):330–4.

    Article  CAS  PubMed  Google Scholar 

  3. Kanas GP, Taylor A, Primrose JN, Langeberg WJ, Kelsh MA, Mowat FS, Alexander DD, Choti MA, Poston G. Survival after liver resection in metastatic colorectal cancer: review and meta-analysis of prognostic factors. Clin Epidemiol. 2012;4:283–301.

    PubMed  PubMed Central  Google Scholar 

  4. Nordlinger B, Quilichini MA, Parc R, Hannoun L, Delva E, Huguet C. Surgical resection of liver metastases from colo-rectal cancers. Int Surg. 1987;72(2):70–2.

    CAS  PubMed  Google Scholar 

  5. Choti MA. Chemotherapy-associated hepatotoxicity: do we need to be concerned? Ann Surg Oncol. 2009;16(9):2391–4.

    Article  PubMed  Google Scholar 

  6. Benoist S, Brouquet A, Penna C, Julié C, El Hajjam M, Chagnon S, Mitry E, Rougier P, Nordlinger B. Complete response of colorectal liver metastases after chemotherapy: does it mean cure? J Clin Oncol. 2006;24(24):3939–45.

    Article  PubMed  Google Scholar 

  7. Tanaka K, Takakura H, Takeda K, Matsuo K, Nagano Y, Endo I. Importance of complete pathologic response to prehepatectomy chemotherapy in treating colorectal cancer metastases. Ann Surg. 2009;250(6):935–42.

    Article  PubMed  Google Scholar 

  8. Bischof DA, Clary BM, Maithel SK, Pawlik TM. Surgical management of disappearing colorectal liver metastases. Br J Surg. 2013;100(11):1414–20.

    Article  CAS  PubMed  Google Scholar 

  9. Adam R, Avisar E, Ariche A, Giachetti S, Azoulay D, Castaing D, Kunstlinger F, Levi F, Bismuth F. Five-year survival following hepatic resection after neoadjuvant therapy for nonresectable colorectal. Ann Surg Oncol. 2001;8(4):347–53.

    Article  CAS  PubMed  Google Scholar 

  10. Lordan JT, Karanjia ND. ‘Close shave’ in liver resection for colorectal liver metastases. Eur J Surg Oncol. 2010;36(1):47–51.

    Article  CAS  PubMed  Google Scholar 

  11. Wolf PS, Park JO, Bao F, Allen PJ, DeMatteo RP, Fong Y, Jarnagin WR, Kingham TP, Gönen M, Kemeny N, Shia J, D’Angelica MI. Preoperative chemotherapy and the risk of hepatotoxicity and morbidity after liver resection for metastatic colorectal cancer: a single institution experience. J Am Coll Surg. 2013;216(1):41–9.

    Article  PubMed  Google Scholar 

  12. Langer B, Bleiberg H, Labianca R, et al. Fluorouracil (FU) plus l-leucovorin (l-LV) versus observation after potentially curative resection of liver or lung metastases from colorectal cancer (CRC): results of the ENG (EORTC/NCIC CTG/GIVIO) randomized trial. Proc Am Soc Clin Oncol. 2002;21:149a (abstr 592).

    Google Scholar 

  13. Portier G, Elias D, Bouche O, et al. 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. 2006;24:4976–82.

    Article  CAS  PubMed  Google Scholar 

  14. Mitry E, Fields AL, Bleiberg H, et al. Adjuvant chemotherapy after potentially curative resection of metastases from colorectal cancer: a pooled analysis of two randomized trials. J Clin Oncol. 2008;26:4906–11.

    Article  CAS  PubMed  Google Scholar 

  15. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein WO, Primrose JN, Walpole ET, Finch-Jones M, Jaeck D, Mirza D, Parks RW, Collette L, Praet M, Bethe U, Van Cutsem E, Scheithauer W, Gruenberger T, EORTC Gastro-Intestinal Tract Cancer Group; Cancer Research UK; Arbeitsgruppe Lebermetastasen und-tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); Australasian Gastro-Intestinal Trials Group (AGITG); Fédération Francophone de Cancérologie Digestive (FFCD). Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial. Lancet. 2008;371(9617):1007–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein WO, Primrose JN, Walpole ET, Finch-Jones M, Jaeck D, Mirza D, Parks RW, Mauer M, Tanis E, Van Cutsem E, Scheithauer W, Gruenberger T, EORTC Gastro-Intestinal Tract Cancer Group; Cancer Research UK; Arbeitsgruppe Lebermetastasen und–tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); Australasian Gastro-Intestinal Trials Group (AGITG); Fédération Francophone de Cancérologie Digestive (FFCD). Perioperative FOLFOX4 chemotherapy and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC 40983): long-term results of a randomised, controlled, phase 3 trial. Lancet Oncol. 2013;14(12):1208–15.

    Article  CAS  PubMed  Google Scholar 

  17. Fong Y. Chemotherapy and resection for colorectal metastases. Lancet Oncol. 2013;14(12):1148–9.

    Article  CAS  PubMed  Google Scholar 

  18. Reddy SK, Zorzi D, Lum YW, Barbas AS, Pawlik TM, Ribero D, Abdalla EK, Choti MA, Kemp C, Vauthey JN, Morse MA, White RR, Clary BM. Timing of multimodality therapy for resectable synchronous colorectal liver metastases: a retrospective multi-institutional analysis. Ann Surg Oncol. 2009;16(7):1809–19.

    Article  PubMed  Google Scholar 

  19. Pinto Marques H, Barroso E, de Jong MC, Choti MA, Ribeiro V, Nobre AM, Carvalho C, Pawlik TM. Peri-operative chemotherapy for resectable colorectal liver metastasis: does timing of systemic therapy matter? J Surg Oncol. 2012;105(6):511–9.

    Article  PubMed  Google Scholar 

  20. Araujo R, Gonen M, Allen P, Blumgart L, DeMatteo R, Fong Y, Kemeny N, Jarnagin W, D’Angelica M. Comparison between perioperative and postoperative chemotherapy after potentially curative hepatic resection for metastatic colorectal cancer. Ann Surg Oncol. 2013;20(13):4312–21.

    Article  PubMed  Google Scholar 

  21. Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230(3):309–18; discussion 318–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Pawlik TM, Olino K, Gleisner AL, Torbenson M, Schulick R, Choti MA. Preoperative chemotherapy for colorectal liver metastases: impact on hepatic histology and postoperative outcome. J Gastrointest Surg. 2007;11(7):860–8.

    Article  PubMed  Google Scholar 

  23. Scoggins CR, Campbell ML, Landry CS, Slomiany BA, Woodall CE, McMasters KM, et al. Preoperative chemotherapy does not increase morbidity or mortality of hepatic resection for colorectal cancer metastases. Ann Surg Oncol. 2009;16(1):35–41.

    Article  PubMed  Google Scholar 

  24. Scartozzi M, Siquini W, Galizia E, Stortoni P, Marmorale C, Berardi R, Fianchini A, Cascinu S. The timing of surgery for resectable metachronous liver metastases from colorectal cancer: better sooner than later? A retrospective analysis. Dig Liver Dis. 2011;43(3):194–8.

    Article  PubMed  Google Scholar 

  25. Spelt L, Hermansson L, Tingstedt B, Andersson R. Influence of preoperative chemotherapy on the intraoperative and postoperative course of liver resection for colorectal cancer metastases. World J Surg. 2012;36(1):157–63.

    Article  PubMed  Google Scholar 

  26. Zhu D, Zhong Y, Wei Y, Ye L, Lin Q, Ren L, Ye Q, Liu T, Xu J, Qin X. Effect of neoadjuvant chemotherapy in patients with resectable colorectal liver metastases. PLoS One. 2014;9(1):e86543.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Martin 2nd RC, Augenstein V, Reuter NP, Scoggins CR, McMasters KM. Simultaneous versus staged resection for synchronous colorectal cancer liver metastases. J Am Coll Surg. 2009;208(5):842–50; discussion 850–2.

    Article  PubMed  Google Scholar 

  28. Abbott AM, Parsons HM, Tuttle TM, Jensen EH. Short-term outcomes after combined colon and liver resection for synchronous colon cancer liver metastases: a population study. Ann Surg Oncol. 2013;20(1):139–47.

    Article  PubMed  Google Scholar 

  29. Adams RB, Aloia TA, Loyer E, Pawlik TM, Taouli B, Vauthey JN, Americas Hepato-Pancreato-Biliary Association; Society of Surgical Oncology; Society for Surgery of the Alimentary Tract. Selection for hepatic resection of colorectal liver metastases: expert consensus statement. HPB (Oxf). 2013;15(2):91–103.

    Article  Google Scholar 

  30. Covey AM, Brown KT, Jarnagin WR, Brody LA, Schwartz L, Tuorto S, Sofocleous CT, D’Angelica M, Getrajdman GI, DeMatteo R, Kemeny NE, Fong Y. Combined portal vein embolization and neoadjuvant chemotherapy as a treatment strategy for resectable hepatic colorectal metastases. Ann Surg. 2008;247(3):451–5.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eugene A. Choi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Sur, M.D., Choi, E.A. (2016). When Should Patients with Liver Metastases from Colorectal Cancer Receive Chemotherapy?. In: Millis, J., Matthews, J. (eds) Difficult Decisions in Hepatobiliary and Pancreatic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-319-27365-5_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27365-5_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27363-1

  • Online ISBN: 978-3-319-27365-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics