Zusammenfassung
Treatment of Synchronous Liver Metastases: Liver-First Concept The choice of the therapeutic strategy in patients with synchronous liver metastases from colorectal cancer must be a multidisciplinary decision in which the different characteristics of each respective patient have to be considered. The most relevant are: complications of the primary tumor, colon or rectum cancer as primary, local ...
Zusammenfassung
Treatment of Synchronous Liver Metastases: Liver-First Concept The choice of the therapeutic strategy in patients with synchronous liver metastases from colorectal cancer must be a multidisciplinary decision in which the different characteristics of each respective patient have to be considered. The most relevant are: complications of the primary tumor, colon or rectum cancer as primary, local staging of rectal cancer, resectability of liver metastases, size and localization of liver metastases and overall condition of the patient. Dependent on these and other parameters for the single patient, a specific therapeutic concept should be worked out. With the 'liver-first' approach, liver metastases are removed prior to a resection of the primary tumor, either with or without perioperative chemotherapy. This reverse strategy is a therapeutic option that is reasonable for different reasons. Whether this treatment sequence is associated with better oncological outcome is, however, not yet proven. Also, the value of neoadjuvant chemotherapy in patients with primary resectable liver metastases still needs to be addressed by prospective randomized trials.
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