Hepatic Metastasis from Colorectal Cancer

Abstract

related to cancer, with a mean average age of 50 years in 75% of cases. 5Mortality rate by age in colorectal cancer is higher in men than in women, and is also twofold in developed (11.6/100,000 habitants) in comparison with developing countries (6.6/100,000 inhabitants), highlighting the region of Eastern Europe, with the highest mortality rate for men and women.Worldwide mortality has increased from 1990 to 2013 (57%); however, in some regions of Europe, North America, and Asia, this has decreased, primarily due to the application of screening methods, such as colonoscopy, which is related with early diagnosis and treatment. 5 ABSTRACTThe liver is the most common site of metastasis in patients with colorectal cancer due to its anatomical situation regarding its portal circulation. About 14 to 18% of patients with colorectal cancer present metastasis at the first medical consultation, and 10 to 25% at the time of the resection of the primary colorectal cancer. The incidence is higher (35%) when a computed tomography (CT) scan is used.In the last decades, a significant increase in the life expectancy of patients with colorectal cancer has been achieved with different diagnostic and treatment programs. Despite these improvements, the presence of metastasis, disease recurrence, and advanced local tumors continue to remain poor prognostic factors.Median survival without treatment is <8 months from the moment of its presentation, and a survival rate at 5 years of 11% is the best prognosis for those who present with local metastasis. Even in patients with limited metastatic disease, 5-year survival is exceptional. Patients with hepatic metastasis of colorectal cancer have a median survival of 5 to 20 months with no treatment. Approximately 20 to 30% of patients with colorectal metastasis have disease confined to the liver, and this can be managed with surgery. Modern surgical strategies at the main hepatobiliary centers have proved that hepatectomy of 70% of the liver can be performed, with a mortality rate of <5%.It is very important to have knowledge of predisposing factors, diagnostic methods, and treatment of hepatic metastasis. However, the establishment of newer, efficient, preventive screening programs for early diagnosis and adequate treatment is vital.

Lymphatic endothelium contributes to colorectal cancer growth via the soluble matrisome component GDF11

“…Colorectal cancer (CRC) is the third most common cancer worldwide, and metastasizing CRC is the main cause of cancer-related mortality in patients. 1 It is now well-recognized that tumor growth, lymphovascular invasion and metastasis are significantly influenced by the dynamic interplay between cancer cells, the extracellular matrix (ECM) and nonmalignant cells, including hematic and lymphatic endothelium, mesenchymal and immune cells. 2 Among the crucial cell types known to shape the tumor microenvironment, lymphatic endothelial cells have recently emerged as key contributors.…”

The prognosis of colorectal cancer liver metastases associated with inflammatory bowel disease: An exploratory analysis

“…Multivariable analysis was conducted using Cox proportional hazards models. Factors corrected in multivariable analysis included those based on the Fong Criteria as well as extrahepatic disease, the presence of synchronous metastasis, lymph node status of the primary CRC, colon or rectal origin, primary T‐stage, microscopically negative resection margins (R0), and KRAS mutation . To account for missing values in multivariable analysis, multiple imputations were performed using the mice package for R 3.3.1.…”

Addition of adjuvant hepatic artery infusion to systemic chemotherapy following resection of colorectal liver metastases is associated with reduced liver‐related mortality

“…Colorectal cancer is the second leading cause of cancer deaths in North America, and the third most common cancer in both men and women worldwide 1‐3 . The liver is the most common site of metastasis 4 . Approximately, 15% to 20% of patients present with synchronous liver disease, of which 70% to 80% are confined to the liver, which makes colorectal liver metastases (CRLM) a common cause of death (COD) in these patients 3‐7 …”

“…The liver is the most common site of metastasis 4 . Approximately, 15% to 20% of patients present with synchronous liver disease, of which 70% to 80% are confined to the liver, which makes colorectal liver metastases (CRLM) a common cause of death (COD) in these patients 3‐7 …”