"Liver‐first" approach for synchronous colorectal liver metastases: is this a justifiable approach?. Issue 3 (March 2013)

• Record Type: Journal Article
• Authors: De Rosa, A.; Gomez, D.; Brooks, A.; Cameron, I.C.
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 20:Issue 3(2013)
• Page Start: 263
• Page End: 270
• Publication Date: 2013-03
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1007/s00534-012-0583-x
• Languages: English
• ISSNs: 1868-6974

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jhbp2000-sec-0001" sec-type="section"> <title>Background</title> <p>To review the outcomes of patients with synchronous colorectal liver metastases (CRLM) treated by the "liver‐first" approach.</p> </sec> <sec id="jhbp2000-sec-0002" sec-type="section"> <title>Methods</title> <p>Relevant articles were reviewed from the published literature using the Medline database. The search was performed using the keywords "colorectal cancer", "liver‐first", "reverse strategy", "liver metastases", "liver resection", and "hepatectomy"</p> </sec> <sec id="jhbp2000-sec-0003" sec-type="section"> <title>Results</title> <p>There have been four retrospective studies that have reported the outcomes of patients with synchronous CRLM following the reverse strategy. The number of patients included ranged from 16 to 27. One study included patients with advanced rectal cancer and synchronous liver metastases only. None of the studies defined resectability for the CRLM. Overall, the morbidity and mortality rates were low. The recurrence rate ranged from 25 to 70 %. One study did not report survival data, and the overall 5 year survival ranged from 31 to 41 %.</p> </sec> <sec id="jhbp2000-sec-0004" sec-type="section"> <title>Conclusion</title> <p>The "liver‐first" approach may be beneficial to a selected group of patients with synchronous CRLM. Patient selection is likely to be determined by their response to down‐staging chemotherapy with or without biological agents.</p> </sec> </abstract>