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Treatment of Liver Metastases from Colorectal Cancer

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Hepato-Pancreato-Biliary Malignancies

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Abstract

Liver metastases from colorectal cancer (CRLM) represent a substantial and growing burden of disease. Prognosis is worse for patients with multiple, large, and bilobar tumors; those with high CEA and tumors with multiple genetic mutations; and patients who present with synchronous CRLM. Aggressive surgical management along with improved systemic chemotherapy over recent years has improved overall survival. Many patients undergo multiple rounds of surgery and chemotherapy and experience significant long-term survival. Using ultrasound-guided nonanatomic partial hepatectomies in combination with ablation, the modern strategy is to preserve as much normal liver parenchyma as possible while eliminating all known CRLM. Laparoscopic liver resection for CRLM has become standard of care for well-selected patients and tumors. Other techniques, such as robotic surgery and arterially directed chemotherapy, are still under investigation.

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References

  1. Kopetz S, Chang GJ, Overman MJ, Eng C, Sargent DJ, Larson DW, Grothey A, Vauthey JN, Nagorney DM, McWilliams RR. Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol. 2009;27(22):3677–83.

    Google Scholar 

  2. 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 318–321

    CAS  Google Scholar 

  3. Krell RW, D’Angelica MI. Treatment sequencing for simultaneous colorectal liver metastases. J Surg Oncol. 2019;119(5):583–93.

    Google Scholar 

  4. Vauthey JN, Kawaguchi Y. Innovation and future perspectives in the treatment of colorectal liver metastases. J Gastrointest Surg. 2020;24(2):492–6.

    Google Scholar 

  5. Moulton CA, Gu CS, Law CH, Tandan VR, Hart R, Quan D, Fairfull Smith RJ, Jalink DW, Husien M, Serrano PE, et al. Effect of pet before liver resection on surgical management for colorectal adenocarcinoma metastases: a randomized clinical trial. JAMA. 2014;311(18):1863–9.

    CAS  Google Scholar 

  6. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein WO, Primrose JN, Walpole ET, Finch-Jones M, et al. 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.

    CAS  Google Scholar 

  7. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, Bechstein WO, Primrose JN, Walpole ET, Finch-Jones M, et al. 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.

    CAS  Google Scholar 

  8. Zhao J, van Mierlo KMC, Gómez-Ramírez J, Kim H, Pilgrim CHC, Pessaux P, Rensen SS, van der Stok EP, Schaap FG, Soubrane O, et al. Systematic review of the influence of chemotherapy-associated liver injury on outcome after partial hepatectomy for colorectal liver metastases. Br J Surg. 2017;104(8):990–1002.

    CAS  Google Scholar 

  9. Abdalla EK, Bauer TW, Chun YS, D’Angelica M, Kooby DA, Jarnagin WR. Locoregional surgical and interventional therapies for advanced colorectal cancer liver metastases: expert consensus statements. HPB (Oxford). 2013;15(2):119–30.

    Google Scholar 

  10. Castaing D, Vibert E, Ricca L, Azoulay D, Adam R, Gayet B. Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg. 2009;250(5):849–55.

    Google Scholar 

  11. Topal H, Tiek J, Aerts R, Topal B. Outcome of laparoscopic major liver resection for colorectal metastases. Surg Endosc. 2012;26(9):2451–5.

    Google Scholar 

  12. Cannon RM, Scoggins CR, Callender GG, McMasters KM, Martin RC. Laparoscopic versus open resection of hepatic colorectal metastases. Surgery. 2012;152(4):567–73; discussion 573–564

    Google Scholar 

  13. Iwahashi S, Shimada M, Utsunomiya T, Imura S, Morine Y, Ikemoto T, Arakawa Y, Mori H, Kanamoto M, Yamada S. Laparoscopic hepatic resection for metastatic liver tumor of colorectal cancer: comparative analysis of short- and long-term results. Surg Endosc. 2014;28(1):80–4.

    Google Scholar 

  14. Montalti R, Berardi G, Laurent S, Sebastiani S, Ferdinande L, Libbrecht LJ, Smeets P, Brescia A, Rogiers X, de Hemptinne B, et al. Laparoscopic liver resection compared to open approach in patients with colorectal liver metastases improves further resectability: oncological outcomes of a case-control matched-pairs analysis. Eur J Surg Oncol. 2014;40(5):536–44.

    CAS  Google Scholar 

  15. Beppu T, Wakabayashi G, Hasegawa K, Gotohda N, Mizuguchi T, Takahashi Y, Hirokawa F, Taniai N, Watanabe M, Katou M, et al. Long-term and perioperative outcomes of laparoscopic versus open liver resection for colorectal liver metastases with propensity score matching: a multi-institutional Japanese study. J Hepatobiliary Pancreat Sci. 2015;22(10):711–20.

    Google Scholar 

  16. Allard MA, Cunha AS, Gayet B, Adam R, Goere D, Bachellier P, Azoulay D, Ayav A, Navarro F, Pessaux P, et al. Early and long-term oncological outcomes after laparoscopic resection for colorectal liver metastases: a propensity score-based analysis. Ann Surg. 2015;262(5):794–802.

    Google Scholar 

  17. de’Angelis N, Eshkenazy R, Brunetti F, Valente R, Costa M, Disabato M, Salloum C, Compagnon P, Laurent A, Azoulay D. Laparoscopic versus open resection for colorectal liver metastases: a single-center study with propensity score analysis. J Laparoendosc Adv Surg Tech A. 2015;25(1):12–20.

    Google Scholar 

  18. Hasegawa Y, Nitta H, Sasaki A, Takahara T, Itabashi H, Katagiri H, Otsuka K, Nishizuka S, Wakabayashi G. Long-term outcomes of laparoscopic versus open liver resection for liver metastases from colorectal cancer: a comparative analysis of 168 consecutive cases at a single center. Surgery. 2015;157(6):1065–72.

    Google Scholar 

  19. Lin Q, Ye Q, Zhu D, Wei Y, Ren L, Zheng P, Xu P, Ye L, Lv M, Fan J, et al. Comparison of minimally invasive and open colorectal resections for patients undergoing simultaneous r0 resection for liver metastases: a propensity score analysis. Int J Color Dis. 2015;30(3):385–95.

    Google Scholar 

  20. Cipriani F, Rawashdeh M, Stanton L, Armstrong T, Takhar A, Pearce NW, Primrose J, Abu Hilal M. Propensity score-based analysis of outcomes of laparoscopic versus open liver resection for colorectal metastases. Br J Surg. 2016;103(11):1504–12.

    CAS  Google Scholar 

  21. Lewin JW, O’Rourke NA, Chiow AKH, Bryant R, Martin I, Nathanson LK, Cavallucci DJ. Long-term survival in laparoscopic vs open resection for colorectal liver metastases: inverse probability of treatment weighting using propensity scores. HPB (Oxford). 2016;18(2):183–91.

    Google Scholar 

  22. Goumard C, Nancy You Y, Okuno M, Kutlu O, Chen HC, Simoneau E, Vega EA, Chun YS, David Tzeng C, Eng C, et al. Minimally invasive management of the entire treatment sequence in patients with stage iv colorectal cancer: A propensity-score weighting analysis. HPB (Oxford). 2018;20(12):1150–6.

    Google Scholar 

  23. Efanov M, Granov D, Alikhanov R, Rutkin I, Tsvirkun V, Kazakov I, Vankovich A, Koroleva A, Kovalenko D. Expanding indications for laparoscopic parenchyma-sparing resection of posterosuperior liver segments in patients with colorectal metastases: comparison with open hepatectomy for immediate and long-term outcomes. Surg Endosc. 2020.

    Google Scholar 

  24. Beard RE, Khan S, Troisi RI, Montalti R, Vanlander A, Fong Y, Kingham TP, Boerner T, Berber E, Kahramangil B, et al. Long-term and oncologic outcomes of robotic versus laparoscopic liver resection for metastatic colorectal cancer: a multicenter, propensity score matching analysis. World J Surg. 2020;44(3):887–95.

    Google Scholar 

  25. Nguyen KT, Marsh JW, Tsung A, Steel JJ, Gamblin TC, Geller DA. Comparative benefits of laparoscopic vs open hepatic resection: a critical appraisal. Arch Surg. 2011;146(3):348–56.

    Google Scholar 

  26. Bagante F, Spolverato G, Strasberg SM, Gani F, Thompson V, Hall BL, Bentrem DJ, Pitt HA, Pawlik TM. Minimally invasive vs. open hepatectomy: a comparative analysis of the national surgical quality improvement program database. J Gastrointest Surg. 2016;20(9):1608–17.

    Google Scholar 

  27. Nguyen KT, Laurent A, Dagher I, Geller DA, Steel J, Thomas MT, Marvin M, Ravindra KV, Mejia A, Lainas P, et al. Minimally invasive liver resection for metastatic colorectal cancer: a multi-institutional, international report of safety, feasibility, and early outcomes. Ann Surg. 2009;250(5):842–8.

    Google Scholar 

  28. Schiffman SC, Kim KH, Tsung A, Marsh JW, Geller DA. Laparoscopic versus open liver resection for metastatic colorectal cancer: a metaanalysis of 610 patients. Surgery. 2015;157(2):211–22.

    Google Scholar 

  29. Fretland Å, Dagenborg VJ, Bjørnelv GMW, Kazaryan AM, Kristiansen R, Fagerland MW, Hausken J, Tønnessen TI, Abildgaard A, Barkhatov L, et al. Laparoscopic versus open resection for colorectal liver metastases: the oslo-comet randomized controlled trial. Ann Surg. 2018;267(2):199–207.

    Google Scholar 

  30. Robles-Campos R, Lopez-Lopez V, Brusadin R, Lopez-Conesa A, Gil-Vazquez PJ, Navarro-Barrios Á, Parrilla P. Open versus minimally invasive liver surgery for colorectal liver metastases (lapophuva): a prospective randomized controlled trial. Surg Endosc. 2019;33(12):3926–36.

    Google Scholar 

  31. Ciria R, Ocaña S, Gomez-Luque I, Cipriani F, Halls M, Fretland Å, Okuda Y, Aroori S, Briceño J, Aldrighetti L, et al. A systematic review and meta-analysis comparing the short- and long-term outcomes for laparoscopic and open liver resections for liver metastases from colorectal cancer. Surg Endosc. 2020;34(1):349–60.

    Google Scholar 

  32. Syn NL, Kabir T, Koh YX, Tan HL, Wang LZ, Chin BZ, Wee I, Teo JY, Tai BC, Goh BKP. Survival advantage of laparoscopic versus open resection for colorectal liver metastases: a meta-analysis of individual patient data from randomized trials and propensity-score matched studies. Ann Surg. 2019.

    Google Scholar 

  33. Kawai T, Goumard C, Jeune F, Savier E, Vaillant JC, Scatton O. Laparoscopic liver resection for colorectal liver metastasis patients allows patients to start adjuvant chemotherapy without delay: a propensity score analysis. Surg Endosc. 2018;32(7):3273–81.

    Google Scholar 

  34. Mbah N, Agle SC, Philips P, Egger ME, Scoggins CR, McMasters KM, Martin RCG. Laparoscopic hepatectomy significantly shortens the time to postoperative chemotherapy in patients undergoing major hepatectomies. Am J Surg. 2017;213(6):1060–4.

    Google Scholar 

  35. Tohme S, Goswami J, Han K, Chidi AP, Geller DA, Reddy S, Gleisner A, Tsung A. Minimally invasive resection of colorectal cancer liver metastases leads to an earlier initiation of chemotherapy compared to open surgery. J Gastrointest Surg. 2015;19(12):2199–206.

    Google Scholar 

  36. Montalti R, Scuderi V, Patriti A, Vivarelli M, Troisi RI. Robotic versus laparoscopic resections of posterosuperior segments of the liver: a propensity score-matched comparison. Surg Endosc. 2016;30(3):1004–13.

    Google Scholar 

  37. Tsung A, Geller DA, Sukato DC, Sabbaghian S, Tohme S, Steel J, Marsh W, Reddy SK, Bartlett DL. Robotic versus laparoscopic hepatectomy: a matched comparison. Ann Surg. 2014;259(3):549–55.

    Google Scholar 

  38. Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, OʼRourke N, Tanabe M, Koffron AJ, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg. 2015;261(4):619–29.

    Google Scholar 

  39. Sucandy I, Cheek S, Golas BJ, Tsung A, Geller DA, Marsh JW. Longterm survival outcomes of patients undergoing treatment with radiofrequency ablation for hepatocellular carcinoma and metastatic colorectal cancer liver tumors. HPB (Oxford). 2016;18(9):756–63.

    Google Scholar 

  40. Abdalla EK, Vauthey JN, Ellis LM, Ellis V, Pollock R, Broglio KR, Hess K, Curley SA. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg. 2004;239(6):818–25; discussion 825–817

    Google Scholar 

  41. Tinguely P, Dal G, Bottai M, Nilsson H, Freedman J, Engstrand J. Microwave ablation versus resection for colorectal cancer liver metastases – a propensity score analysis from a population-based nationwide registry. Eur J Surg Oncol. 2020;46(3):476–85.

    Google Scholar 

  42. Takahashi H, Berber E. Role of thermal ablation in the management of colorectal liver metastasis. Hepatobiliary Surg Nutr. 2020;9(1):49–58.

    Google Scholar 

  43. Adam R, Imai K, Castro Benitez C, Allard MA, Vibert E, Sa Cunha A, Cherqui D, Baba H, Castaing D. Outcome after associating liver partition and portal vein ligation for staged hepatectomy and conventional two-stage hepatectomy for colorectal liver metastases. Br J Surg. 2016;103(11):1521–9.

    CAS  Google Scholar 

  44. Serenari M, Alvarez FA, Ardiles V, de Santibañes M, Pekolj J, de Santibañes E. The alpps approach for colorectal liver metastases: impact of kras mutation status in survival. Dig Surg. 2018;35(4):303–10.

    Google Scholar 

  45. Schnitzbauer AA, Schadde E, Linecker M, Machado MA, Adam R, Malago M, Clavien PA, de Santibanes E, Bechstein WO. Indicating alpps for colorectal liver metastases: a critical analysis of patients in the international alpps registry. Surgery. 2018;164(3):387–94.

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Liver Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Richard S. Hoehn, Samer T. Tohme & David A. Geller

Authors
  1. Richard S. Hoehn
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  2. Samer T. Tohme
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  3. David A. Geller
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Correspondence to David A. Geller .

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Editors and Affiliations

  1. Medical Director, Capital Health Cancer Center, Director, CH Pancreas Center of Excellence, Director, CH Liver Center of Excellence, Pennington, NJ, USA

    Cataldo Doria

  2. Director of Interventional Gastroenterology, Capital Health Medical Center, Pennington, NJ, USA

    Jason N. Rogart

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Hoehn, R.S., Tohme, S.T., Geller, D.A. (2022). Treatment of Liver Metastases from Colorectal Cancer. In: Doria, C., Rogart, J.N. (eds) Hepato-Pancreato-Biliary Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-030-41683-6_8

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  • DOI: https://doi.org/10.1007/978-3-030-41683-6_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-41682-9

  • Online ISBN: 978-3-030-41683-6

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