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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(5): 391–396. doi:10.14735/amgh2018391.

Therapy of colorectal carcinoma liver metastases

Jiří Pudil Orcid.org  1, Stanislav Batko2, Kateřina Menclová3, Michael Rousek3, Miroslav Ryska4

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Summary

Introduction: Sixty percent of patients with colorectal carcinoma develop liver metastases (LMKRK). Surgical treatment is the most frequent treatment modality and has a 5-year survival rate of near 50%. However, less than 20% of patients with LMKRK undergo lLiver resection. Systematic treatment may allow resection of primary unresectable patients or may significantly prolong life expectancy. The optimal treatment strategy is decided by a multidisciplinary team. Surgical treatment: We defined the technical and oncological aspects of resectability and evaluated the incidence of liver remnants, eventually possibilities of its enlargement. We also mention the different surgical treatment methods including type of resection method, multi-step approach, liver first approach, and radiofrequency ablation. Systemic treatment: Developes rapidly, current options for chemotherapy and biological treatment are mentioned. Also, the indications for perioperative treatment in patients with resectable disease are mentioned. Conversion therapy in patients with primary unresecable disease is discussed. Conclusion: Despite developments in systematic therapy, liver resection is still the best curative method for LMKRK treatment. Close cooperation with liver surgeon and a clinical oncologist within a multidisciplinary team is a crucial condition for increasing resectability in patients with LMKRK.

Keywords

liver metastases, colorectal cancer, liver resection, systhemic therapy

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