Guidelines for the detection and treatment of liver metastases of colorectal cancer |
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Authors: | A Abad J Figueras C Valls A Carrato F Pardo E Díaz-Rubio E Aranda |
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Institution: | (1) Medical Oncology Service, University Hospital Germans Trias i Pujol Catalan Institute of Oncology (ICO), ES-08916 Badalona, Barcelona, Spain;(2) Department of Surgery, Hospital Josep Trueta, Girona, Spain;(3) Department of Radiology, Hospital Universitario de Bellvitge, Barcelona, Spain;(4) Medical Oncology Service, Hospital General Universitario, Elche, Alicante, Spain;(5) Department of Surgery, Clínica Universitaria de Navarra, Pamplona, Spain;(6) Medical Oncology Service, Hospital Clínico San Carlos, Madrid, Spain;(7) Medical Oncology Service, Hospital Universitario Reina Sofía, Córdoba, Spain |
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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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Keywords: | Colorectal cancer Liver metastases Surgical treatment Neoadjuvant chemotherapy |
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