Surgical strategy for synchronous colorectal liver metastases
10.3760/cma.j.issn.1673-9752.2009.05.004
- VernacularTitle:结直肠癌同时性肝转移的外科治疗
- Author:
Yingjiang YE
;
Shan WANG
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Liver metastasis,synchronous;
Surgical procedures
- From:Chinese Journal of Digestive Surgery
2009;8(5):327-330
- CountryChina
- Language:Chinese
-
Abstract:
Synchronous colorectal liver metastases occurs in 15%-25% of patients with newly diagnosed colorectal cancer. Hepatic resoction has been accepted as the only option that offers long-term survival for patients with liver metastases. However, the optimal timing and sequence of resection for synchronous colorectal liver metastases still remain controversial. Also, the use of neoadjuvant chemotherapy which should be initiated in patients with resectable synchronous liver metastases is not consistent. In order to use evidence-based medicine to clarify indications for one-stage hepatic resection of liver metastases, a multi-center clinical trial was pedormed to normalize the surgical strategy of synchronous liver metastases. In summary, in selected patients, one-stage approach is comparable to the two-stage procedure in mortality and morbidity rates and longterm survival. One-stage procedure should be performed according to the site of primary tumor, age, the volume of residual healthy liver. Preoperative chemotherapy is effective in downstaging the tumor and reducing the resected liver volume, but it also brings damage to the liver and has adverse effect on onestage hepatic resection.
