Author | Conference | Journal | Organization | Year | DOI
Look for results that meet for the following criteria:
Academic
Publications
NEW STRATEGIES IN LIVER SURGERY FOR IV STAGE METASTATIC COLORECTAL CANCER

NEW STRATEGIES IN LIVER SURGERY FOR IV STAGE METASTATIC COLORECTAL CANCER,10.5272/jimab.2012181.231,Nikola Y. Kolev,Anton Y. Tonev,Valentin L. Ignatov

Edit
NEW STRATEGIES IN LIVER SURGERY FOR IV STAGE METASTATIC COLORECTAL CANCER  
BibTex | RIS | RefWorks Download
With recent advances in chemotherapy, traditional clinicopathological factors should not be used to exclude otherwise resectable patients from surgery. Pathological or clinical response to chemotherapy has become valuable in determining the treatment for individual patients. Portal vein embolization and two-stage operation with ablative therapy and preoperative chemotherapy should be considered for unresectable liver metastases located in a liver remnant that is at the minimum volume required for survival. The recent E0RTC 40983 trials regarding preoperative chemotherapy for resectable CLM have failed to demonstrate a clear significant advantage. However, patients with a low clinical risk score for the recurrence, such as several metastases of less than 4 cm, and who are fit candidates for liver resection are often offered immediate surgery. Patients at high clinical risk should also be considered for neoadjuvant chemotherapy. One forthcoming and appealing strategy is to adapt postoperative treatment according to tumor response as evaluated by neoadjuvant chemotherapy or by the presence of individual tumor biomarker such as the Kras mutation or single- nucleotide polymorphisms. This could avoid the overtreatment of nonresponsive patients and enable a more tailored approach to treat an individual patient's disease. The treatment paradigm for CLM is rapidly changing with the development of newer anticancer chemotherapeutic agents. metastases have median survival as 12 to 15 months and 5-year survival less than 5%. In spite of the introduction of a many new agents the median survival for patients with stage IV disease treated with the best chemotherapy remains only 25 months.(3, 4) Liver resection remains the best option for achieving long-term survival despite the new treatmen modalities. No consensus is available on if aggressive surgery is proper for CLM; there are some arguments the survival benefit after this procedure is due to better patient selection rather than of the treatment strategy. The tumor biology is probably prevailing no matter of the treatment applied. Therefore the only way to change the disease course for some patients is complete hepatic resection for CLM and integrated therapy with surgery and systemic chemotherapy is of increased importance. Patients with CLM previously considered as unresectable now have a chance for a curative resection because of the new development in multimodality treatment. Now the 5-year overall survival rate after surgery reaches 58%. (5-10)
Published in 2012.
Cumulative Annual
View Publication
The following links allow you to view full publications. These links are maintained by other sources not affiliated with Microsoft Academic Search.
Share this on