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Perioperative Chemotherapy for Liver Metastasis of Colorectal Cancer: Lessons Learned and Future Perspectives

  • Lower Gastrointestinal Cancers (AB Benson, Section Editor)
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Opinion statement

Colorectal cancer (CRC) is a major public health problem and the 2nd leading-cause of cancer-related death worldwide. Around 30% of patients present with metastatic disease and 50% of those with early disease will eventually relapse. The metastatic spread occurs mainly to the liver, which is the exclusive site in 30–40% of the cases. Surgery is the main curative option for liver recurrence, but only one out of five patients are eligible for resection. Moreover, even if surgery is feasible, recurrence rate is high, occurring in up to 75% of patients. Therefore, additional treatment to improve these disappointing outcomes has been sought. Adjuvant and perioperative chemotherapy aim to eradicate early micrometastatic disease, decreasing recurrence rates, and improving survival outcomes. Different chemotherapy regimens, mainly extrapolated from the adjuvant experience, have showed conflicting results, with improvements in disease free but not in overall survival. The addition of targeted therapies to chemotherapy has improved response rates and resectability when administered preoperatively, but did not have an impact on survival in the adjuvant setting. There is a need to critically synthetize the available evidence on perioperative and conversion therapy from the past years, and appraise areas of current research and potential future directions.

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Maria C. Riesco-Martinez is funded by the AECC (CLSEN19003RIES).

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  1. Maria C. Riesco-Martinez and Andrea Modrego have equally contributed to this work.

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  1. Medical Oncology Department, Hospital Universitario 12 de Octubre, imas 12, UCM, Avda Cordoba km 5.4, 28041, Madrid, Spain

    Maria C. Riesco-Martinez MD, PhD, Andrea Modrego, Paula Espinosa-Olarte, Anna La Salvia & Rocio Garcia-Carbonero MD, PhD

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Rocio Garcia-Carbonero has participated as an invited speaker or consultant for AAA, Advanz Pharma, Amgen, Bayer, HMP, Ipsen, Merck, Midatech, MSD, Novartis, Pierre Fabre, Roche, Servier. Rocio Garcia-Carbonero has also received financial support for investigator-initiated trials from BMS, MSD, Pfizer. Maria C. Riesco-Martinez has participated as invited speaker or consultant for AAA, Servier, Roche, Merck, and Bayer and received financial support for investigator-initiated trials from BMS and MSD. Andrea Modrego, Paula Espinosa-Olarte, and Anna La Salvia declare no conflicts of interest.

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Riesco-Martinez, M.C., Modrego, A., Espinosa-Olarte, P. et al. Perioperative Chemotherapy for Liver Metastasis of Colorectal Cancer: Lessons Learned and Future Perspectives. Curr. Treat. Options in Oncol. 23, 1320–1337 (2022). https://doi.org/10.1007/s11864-022-01008-5

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