Surgical Resection of Colorectal Liver Metastases in Patients with Expanded Indications: A Single-Center Experience with 501 Patients

Abstract

This study suggested that liver resection should be indicated in patients with expanded indications. The extent of the benefits of preoperative and postoperative chemotherapy needs to be quantitated.

Surgical treatment of liver metastases from colorectal carcinoma in elderly patients. When is it worthwhile?

“…Any recurrences that were deemed operable were resected, including locoregional or anastomotic recurrences. During the last 6 years, radiofrequency (RF) interstitial destruction was used in combination with resection for otherwise unresectable patients [14].…”

The management of colorectal liver metastases: Expanding the role of hepatic resection in the age of multimodal therapy

“…It is likely that this modality will be used selectively in the first instance to define extrahepatic resectability, in-situ liver recurrence, the delineation of widespread extra-abdominal disease and in some cases of locally advanced disease at presentation with metastatic disease and an unresected primary. To date, the cost-benefits of its use particularly when the post-hepatectomy course is complicated in aggressive surgery and in selected cases of resectable extrahepatic disease with contiguous organ extension (with or without locoregionally recurrent CRC) is unclear [10,11,58].…”

“…The philosophy (and definition) of hepatic resectability in colorectal liver metastatic disease has changed in the last few years where more extended resections are offered in selected cases somewhat regardless of the number of metastases [8,9], their locoregional invasiveness or even the presence of demonstrable extrahepatic disease [10,11]. This approach has been predicated on several important factors.…”

Effect of surgical resection of metastatic disease on immune tolerance to cancer. How a systemic disease could be controlled by a local therapy

“…The current definition of "unresectable" includes: involvement of more than 70% of the liver or more than 6 segments [4]. Those patients considered resectable must be offered the 40% survival rate at 5 years that can be achieved by surgery [5]. However, most patients with CLM will present with unresectable disease.…”