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Article: Colorectal liver metastases: An update on multidisciplinary approach

TitleColorectal liver metastases: An update on multidisciplinary approach
Authors
KeywordsColorectal cancer
Liver metastases
Hepatic resection
Neoadjuvant therapy
Adjuvant chemotherapy
Issue Date2019
PublisherBaishideng Publishing Group Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1948-5182/index.htm
Citation
World Journal of Hepatology, 2019, v. 11 n. 2, p. 150-172 How to Cite?
AbstractLiver metastasis is the commonest form of distant metastasis in colorectal cancer. Selection criteria for surgery and liver-directed therapies have recently been extended. However, resectability remains poorly defined. Tumour biology is increasingly recognized as an important prognostic factor; hence molecular profiling has a growing role in risk stratification and management planning. Surgical resection is the only treatment modality for curative intent. The most appropriate surgical approach is yet to be established. The primary cancer and the hepatic metastasis can be removed simultaneously or in a two-step approach; these two strategies have comparable long-term outcomes. For patients with a limited future liver remnant, portal vein embolization, combined ablation and resection, and associating liver partition and portal vein ligation for staged hepatectomy have been advocated, and each has their pros and cons. The role of neoadjuvant and adjuvant chemotherapy is still debated. Targeted biological agents and loco-regional therapies (thermal ablation, intra-arterial chemo- or radio-embolization, and stereotactic radiotherapy) further improve the already favourable results. The recent debate about offering liver transplantation to highly selected patients needs validation from large clinical trials. Evidence-based protocols are missing, and therefore optimal management of hepatic metastasis should be personalized and determined by a multi-disciplinary team.
Persistent Identifierhttp://hdl.handle.net/10722/271290
ISSN
2015 SCImago Journal Rankings: 0.858
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorChow, FCL-
dc.contributor.authorChok, KSH-
dc.date.accessioned2019-06-24T01:07:02Z-
dc.date.available2019-06-24T01:07:02Z-
dc.date.issued2019-
dc.identifier.citationWorld Journal of Hepatology, 2019, v. 11 n. 2, p. 150-172-
dc.identifier.issn1948-5182-
dc.identifier.urihttp://hdl.handle.net/10722/271290-
dc.description.abstractLiver metastasis is the commonest form of distant metastasis in colorectal cancer. Selection criteria for surgery and liver-directed therapies have recently been extended. However, resectability remains poorly defined. Tumour biology is increasingly recognized as an important prognostic factor; hence molecular profiling has a growing role in risk stratification and management planning. Surgical resection is the only treatment modality for curative intent. The most appropriate surgical approach is yet to be established. The primary cancer and the hepatic metastasis can be removed simultaneously or in a two-step approach; these two strategies have comparable long-term outcomes. For patients with a limited future liver remnant, portal vein embolization, combined ablation and resection, and associating liver partition and portal vein ligation for staged hepatectomy have been advocated, and each has their pros and cons. The role of neoadjuvant and adjuvant chemotherapy is still debated. Targeted biological agents and loco-regional therapies (thermal ablation, intra-arterial chemo- or radio-embolization, and stereotactic radiotherapy) further improve the already favourable results. The recent debate about offering liver transplantation to highly selected patients needs validation from large clinical trials. Evidence-based protocols are missing, and therefore optimal management of hepatic metastasis should be personalized and determined by a multi-disciplinary team.-
dc.languageeng-
dc.publisherBaishideng Publishing Group Co., Ltd. The Journal's web site is located at http://www.wjgnet.com/1948-5182/index.htm-
dc.relation.ispartofWorld Journal of Hepatology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectColorectal cancer-
dc.subjectLiver metastases-
dc.subjectHepatic resection-
dc.subjectNeoadjuvant therapy-
dc.subjectAdjuvant chemotherapy-
dc.titleColorectal liver metastases: An update on multidisciplinary approach-
dc.typeArticle-
dc.identifier.emailChok, KSH: chok6275@hku.hk-
dc.identifier.authorityChok, KSH=rp02110-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.4254/wjh.v11.i2.150-
dc.identifier.pmid30820266-
dc.identifier.pmcidPMC6393711-
dc.identifier.scopuseid_2-s2.0-85062657173-
dc.identifier.hkuros297969-
dc.identifier.volume11-
dc.identifier.issue2-
dc.identifier.spage150-
dc.identifier.epage172-
dc.publisher.placeUnited States-

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