Validity of observation interval for synchronous hepatic metastases of colorectal cancer: changes in hepatic and extrahepatic metastatic foci

Shimizu, Yasuhiro; Yasui, Kenzo; Sano, Tsuyoshi; Hirai, Takashi; Kanemitsu, Yukihide; Kono, Koji; Kato, Tomoyuki

doi:10.1007/s00423-007-0258-2

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…In all, 207 patients did not fulfill the selection criteria for resection: recurrence at the primary site ( n = 11), extrahepatic or extrathoracic metastases ( n = 85), unresectable liver lesions ( n = 81), unresectable lung lesions ( n = 30). When metastasis to the liver and/or lung was detected at the time of diagnosis of colorectal cancer, we resected the primary tumor first and, in the absence of disease progression, performed the metastasectomy 3 months later [21]. When patients presented with simultaneous liver and lung metastases, we resected the hepatic lesion(s) first to rule out extrahepatic abdominal lesions.…”

Section: Methodsmentioning

confidence: 99%

Outcomes After Hepatic and Pulmonary Metastasectomies Compared With Pulmonary Metastasectomy Alone in Patients With Colorectal Cancer Metastasis to Liver and Lungs

et al. 2013

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Section: Methodsmentioning

confidence: 99%

Outcomes After Hepatic and Pulmonary Metastasectomies Compared With Pulmonary Metastasectomy Alone in Patients With Colorectal Cancer Metastasis to Liver and Lungs

et al. 2013

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“…In the early 2000s, some authors proposed to adopt a time-test before surgery in patients with resectable colorectal liver metastases ( i.e. an observation period to evaluate the tumor evolution)[ 39 - 41 ]. One-third to half of the patients developed additional lesions during the time-test and were excluded from resection.…”

Section: Moving Toward a Dynamic Viewmentioning

confidence: 99%

Is precision medicine for colorectal liver metastases still a utopia? New perspectives by modern biomarkers, radiomics, and artificial intelligence

Viganò¹,

Arachchige²,

Fiz³

2022

WJG

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The management of patients with liver metastases from colorectal cancer is still debated. Several therapeutic options and treatment strategies are available for an extremely heterogeneous clinical scenario. Adequate prediction of patients’ outcomes and of the effectiveness of chemotherapy and loco-regional treatments are crucial to reach a precision medicine approach. This has been an unmet need for a long time, but recent studies have opened new perspectives. New morphological biomarkers have been identified. The dynamic evaluation of the metastases across a time interval, with or without chemotherapy, provided a reliable assessment of the tumor biology. Genetics have been explored and, thanks to their strong association with prognosis, have the potential to drive treatment planning. The liver-tumor interface has been identified as one of the main determinants of tumor progression, and its components, in particular the immune infiltrate, are the focus of major research. Image mining and analyses provided new insights on tumor biology and are expected to have a relevant impact on clinical practice. Artificial intelligence is a further step forward. The present paper depicts the evolution of clinical decision-making for patients affected by colorectal liver metastases, facing modern biomarkers and innovative opportunities that will characterize the evolution of clinical research and practice in the next few years.

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“…The traditional approach to synchronous rectal cancer liver metastases has been a staged operation where proctectomy is performed followed by hepatectomy. The benefit of this approach is that it allows for the full metastatic load and biological aggressiveness of the tumor to be identified before the morbidity associated with hepatectomy is encountered [ 87 , 88 , 89 , 90 ]. Traditionally thought to avoid the increased morbidity and mortality from the combination of the two major operations, several studies demonstrated no increased morbidity or mortality when proctectomy is combined with partial hepatectomy [ 91 , 92 , 93 ].…”

Section: Distant Solid Organ Metastasis and Peritoneal Carcinomatosis...mentioning

confidence: 99%

New Frontiers in Management of Early and Advanced Rectal Cancer

Wlodarczyk

Lee

2022

Cancers

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It is important to understand advances in treatment options for rectal cancer. We attempt to highlight advances in rectal cancer treatment in the form of a systematic review. Early-stage rectal cancer focuses on minimally invasive endoluminal surgery, with importance placed on patient selection as the driving factor for improved outcomes. To achieve a complete pathologic response, various neoadjuvant chemoradiation regimens have been employed. Short-course radiation therapy, total neoadjuvant chemotherapy, and others provide unique advantages with select patient populations best suited for each. With a clinical complete response, a “watch and wait” non-operative surveillance has been introduced with preliminary equivalency to radical resection. Various modalities for total mesorectal excision, such as robotic or transanal, have advantages and can be utilized in select patient populations. Tumors demonstrating solid organ or peritoneal spread, traditionally defined as unresectable lesions conveying a terminal diagnosis, have recently undergone advances in hepatic and pulmonary metastasectomy. Hepatic and pulmonary metastasectomy has demonstrated clear advantages in 5-year survival over standard chemotherapy. With the peritoneal spread of colorectal cancer, HIPEC with cytoreductive therapy has emerged as the preferred treatment. Understanding the various therapeutic interventions will pave the way for improved patient outcomes.

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Validity of observation interval for synchronous hepatic metastases of colorectal cancer: changes in hepatic and extrahepatic metastatic foci

Abstract: Reevaluation after an observation interval allows accurate understanding of the number and location of hepatic metastases and is beneficial in determining candidates for surgery and in selecting treatment plan.

Cited by 9 publications

References 17 publications

Outcomes After Hepatic and Pulmonary Metastasectomies Compared With Pulmonary Metastasectomy Alone in Patients With Colorectal Cancer Metastasis to Liver and Lungs

Outcomes After Hepatic and Pulmonary Metastasectomies Compared With Pulmonary Metastasectomy Alone in Patients With Colorectal Cancer Metastasis to Liver and Lungs

Is precision medicine for colorectal liver metastases still a utopia? New perspectives by modern biomarkers, radiomics, and artificial intelligence

New Frontiers in Management of Early and Advanced Rectal Cancer

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