PM offers a chance for long-term survival in selected patients with CRC and previously resected liver metastasis. Thoracic LN involvement predicted poor prognosis; therefore, significant efforts should be undertaken for adequate staging of the mediastinum before PM. In addition, adequate intraoperative LN sampling allows proper prognostic stratification and enrollment in novel adjuvant therapy trials.
Medical therapy for hepatocellular carcinoma (HCC) is an area of active investigation because fewer than 25% of patients are candidates for curative resection or transplantation. Single agent doxorubicin, the former standard of care, generated a 10% tumor response but resulted in substantial toxicity. The resulting recommendation of the NCCN has been to administer cytotoxic chemotherapy only under clinical protocol. More recently, newer drugs with more specific targets have forced re-consideration of palliative chemotherapy in clinical practice. Bevacizumab is a promising therapy but data is limited to Phase 2 trials without impressive results. Sorafenib is the prototype multi-kinase inhibitor, which has demonstrated some but limited survival benefit in advanced HCC. This has subsequently become the standard of care. Epidermal growth factor receptor, the target of rapamycin (mTOR) pathway, transforming growth factor-β, and cyclin-dependent kinases have been recent targets of ongoing study for potential therapeutics. Overall, current therapeutics have been so promising that adjuvant therapy after curative treatment in under investigation to reduce recurrence.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.