Presurgical chemotherapy in patients being considered for liver resection. Review uri icon

Overview

abstract

  • The liver is a frequent site of metastatic disease for colorectal cancer patients. Approximately 15% of patients have liver metastases at diagnosis and another 50% develop metastatic disease to the liver over the course of their disease. Advances in systemic chemotherapy and surgical techniques for hepatic resection have led to longer survival times for these patients. There is no doubt that unresectable patients benefit from systemic chemotherapy. For patients who have resectable disease, the timing of chemotherapy is still not clear. This review addresses the pros and cons of presurgical chemotherapy. The benefits of preoperative chemotherapy include decreasing tumor size, controlling micrometastatic disease, assessing activity of chemotherapy, improving chemotherapy tolerance, and perhaps allowing some prediction of the success of liver resection. The risks for presurgical chemotherapy include liver toxicity, the risk for progression or growth of new sites, secondary splenomegaly, selection of resistant clones, and the possibility of leaving behind active tumor that is no longer seen because of a complete radiographic response. The challenge for the future is to develop a multidisciplinary team approach that can design the best treatment plan for patients with liver metastases.

publication date

  • July 1, 2007

Research

keywords

  • Antineoplastic Combined Chemotherapy Protocols
  • Liver Neoplasms
  • Neoadjuvant Therapy
  • Neoplasm Metastasis

Identity

Scopus Document Identifier

  • 34548242252

Digital Object Identifier (DOI)

  • 10.1634/theoncologist.12-7-825

PubMed ID

  • 17673614

Additional Document Info

volume

  • 12

issue

  • 7