medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2000, Number 2

<< Back Next >>

Cir Gen 2000; 22 (2)

Surgical and non-surgical treatment of liver metastases from colo-rectal cancer

Mondragón SRJ

Language: Spanish
References: 47
Page: 164-171
PDF size: 87.91 Kb.


ABSTRACT

Objective: To up-date the information on management of colorectal cancer patients coursing with hepatic metastases.
Setting: Third level health care hospital.
Data collection: Review and analysis of the literature from the last years on surgical and non-surgical treatment of metastatic lesions to the liver due to colorectal cancer.
Selection of studies: We analyzed the articles publi-shed by the groups with the greatest experience in treating hepatic metastases in Mexico and worldwide (47 references).
Data extraction: We analyzed the information relevant to hepatic resection results in colorectal metastases, morbidity, surgical mortality, survival and prognostic factors, role of reresection and of adjuvant chemotherapy, results from regional and systemic chemotherapy as well as from interstitial therapies, such as cryotherapy.
Results: Hepatic resection is the ideal treatment for metastatic lesions of colorectal cancer as it provides the best long-term survival rates. At present, surgical morbidity and mortality are of 30 and 5%, respectively, and 5-year survival is of 30%. Unfortunately, few are candidates for resection and most present non-resectable lesions, in whom cryotherapy combined with intraarterial chemotherapy offers the best results. Surgical morbidity and mortality rates are comparable to those of resection, and 5 years survival is of 15%. Other handling procedures do not offer the same results, however, more comparative studies are needed to determine their role in the future.
Conclusion: Adequate selection of patients will allow to obtain better results with resective and non-resective surgery, of the latter cryotherapy offers the best results.


REFERENCES

  1. Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics, 1996. CA Cancer J Clin 1996; 46: 5-27.

  2. Secretaria de Salud. Dirección General de Epidemiología. Compendio de estadísticas de morbilidad por neoplasias malignas 1982-1989. Registro Nacional del Cáncer. México: Secretaría de Salud;1993.

  3. Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Goodman PJ et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med 1990; 322: 352-8.

  4. Fildler IJ. Macrophages and metastasis. a biological approach to cancer therapy. Cancer Res 1985; 45: 4714-26.

  5. Bozzetti F, Bignami P, Morabito A, Doci R, Gennari L. Pattern of failure following surgical resection of colorrectal cancer liver metastasis: Rationale for a multimodel approach. Ann Surg 1987; 205: 264-70.

  6. Fortner JG, Silva JS, Golbey RB, Cox EB, Maclean BJ. Multivariative analysis of a personal series of 247 consecutive patients with liver metastases from colorectal cancer. I. Treatment by hepatic resection. Ann Surg 1984; 199: 306-16.

  7. Doci R, Gennari L, Bignami P, Montalvo F, Morabito A, Bozzetti F. One hundred patients with hepatic metastases from colorectal cancer treated by resection: Analysis of prognostic determinants. Br J Surg 1991; 78: 797-801.

  8. Scheele J, Stangl R, Altendorf-Hafmann A, Gall FP. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 1991; 110: 13-29.

  9. Iwatsuki S, Starzl TE. Personal experience with 411 hepatic resections. Ann Surg 1988; 4: 421-32; discussion 432-4.

  10. Schlag P, Hohenberger P, Herfarth C. Resection of liver metastases in colorectal cancer: competitive analysis of treatment results in synchronous versus metachronous metastases. Eur J Surg Oncol 1990; 16: 360-5.

  11. Fong Y, Blumgart LH, Fortner JG, Brennan MF. Pancreatic or liver resection for malignancy is safe and effective for the elderly. Ann Surg 1995; 222: 426-34; discussion 434-7.

  12. Mondragón-Sánchez R, Oñate-Ocaña LF, Ruiz-Molina JM, Aiello-Crocifoglio V. Indications and results of liver resection from colorectal liver metastasis in Mexico. Hepato-Gastroenterol. En prensa.

  13. Wood CB, Gillis CR, Blumgart LH. A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Oncol 1976;2:285-8.

  14. Mondragón-Sánchez R, Ochoa-Carrillo FJ. Metástasis hepáticas de cáncer colorrectal. Rev Inst Nac Canc 1997; 43: 147-54.

  15. Wagner JS, Adson MA, van Heerden JA, Adson MH, Ilstrup DM. The natural history of hepatic metastases from colorectal cancer. Ann Surg 1984; 199: 502-507; discussion 507-8

  16. Saenz NC, Cady B, McDermott WV Jr, Steele GD Jr. Experience with colorectal carcinoma metastatic to the liver. Surg Clin North Am 1989;69:361-70.

  17. Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg 1995; 19: 59-71.

  18. Mercado MA, Medina H, Rossano A, Acosta E, Rodríguez M. Enfermedad metastásica de hígado. Enfoque quirúrgico. Rev Gastroenterol Mex 1997; 62: 235-8.

  19. Hughes KS, Simon R, Songhorabodi S, Adsom MA, Ilsrtrup DM, Forner JG, et al. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of patterns of recurrence. Surgery 1988;103: 278-84.

  20. Adson MA, van Heerden JA, Adson MH, Wagner JS, Ilstrup DM. Resection of hepatic metastases from colorectal cancer. Arch Surg 1984; 119: 647-51.

  21. Hughes KS, Rosestein RB, Songhorabodi S, Adson MA, Ilstrup DM, Fortner JG, et al. Resection of the liver for colorectal carcinoma metastasis: a multi-institutional study of long-term survivors. Dis Colon Rectum 1988; 31: 1-4.

  22. Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet 1985; 161: 346-50.

  23. Couinaud C. Lobes et segments hepatiques. Note sur larchitecture anatomique et chirurgical du foie. La Presse Medicale 1954; 62: 709.

  24. Rosen CB, Nagorney DM, Taswell HF, Helgeson SL, Ilstrup DM, van Heerden JA, et al. Perioperative blood transfusion and determinants of survival after liver resection for metastatic colorectal carcinoma. Ann Surg 1992; 216: 493-4; discussion 504-5.

  25. Adson MA. Resection of liver metastases when is it worthwhile?. World J Surg 1987; 11: 511-20.

  26. August DA, Sugarbaker PH, Ottow RT, Gianola FJ, Schneider PD. Hepatic resection of colorectal metastases. Influence of clinical factors and adjuvant intraperitoneal 5 fluorouracil via Tenckhoff catheter on survival. Ann Surg 1985; 201: 210-8.

  27. Fortner JG. Recurrence of colorectal cancer after hepatic resection. Am J Surg 1988; 155: 378-82.

  28. Bozettei F, Bignami P, Montalto F, Doci R, Gennari L. Repeated hepatic resection for recurrent metastases from colorectal cancer. Br J Surg 1992; 79: 146-8.

  29. Hohenberger P, Schlag P, Schwartz V, Herfath C. Tumor recurrence and options for further treatment after resection of liver metastases in patients with colorectal cancer. J Surg Oncol 1990; 44: 245-51.

  30. Fernandez-Trigo V, Shamsa F, Sugarbaker PH. Repeat liver resections from colorectal metastases. Surgery 1995; 117: 296-304.

  31. Isacoff WH, Borud K. Chemotherapy for the treatment of patients with metastatic colorectal cancer: an overview. World J Surg 1997;21:748-62

  32. Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer evidence in terms of response rate. Advanced Colorectal Cancer Meta-Analysis Project. J Clin Oncol 1992; 10: 896-903.

  33. Seitz LE, Cunningham D, Roth U, Oliver IN. Final results and survival data of a large randomized trial of tomudex in advanced colorectal cancer confirm comparable efficacy to 5-fluorouracil plus leucovorin. Proc Am Soc Clin Oncol 1996; 15: 201.

  34. Rougier P, Paillot B, Laplanche A, Morvan F. Multicentric phase study of first line CPT-11 (irinotecan) in advanced colorectal cancer: Preliminary results. Proc Am Soc Clin Oncol 1994; 13: 200.

  35. Bismuth H, Adam R, Levi F, Farabos C, Waechter F, Castaing D et al. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 1996; 224: 509-20; discussion 520-2.

  36. Venook AP, Warren RS. Regional chemotherapy approaches for primary and metastatic liver tumors. Surg Oncol Clin N Am 1996; 5: 411-27.

  37. Kemeny N, Seiter K, Niedzwiecki D, Chapman D, Sigurdson E, Cohen A, et al. A randomized trial of intrahepatic infusion of fluorodeoxyuridine with dexamethasone versus fluorodeoxyuridine alone in the treatment of metastatic colorectal cancer. Cancer 1992; 69: 327-34.

  38. Allen-Mersh TG, Earlam S, Fordy C, Abrams K, Houghton J. Quality of life and survival with continuous hepatic artery floxuridine infusion for colorectal liver metastases. Lancet 1994; 344: 1255-60.

  39. Reapprasial of hepatic arterial infusion in the treatment of nonresectable liver metastases from colorectal cancer. Meta-Analysis Group in Cancer. J Natl Cancer Inst 1996; 88: 252-8.

  40. Laffer UT, Metzger U. Intraportal chemotherapy for colorectal hepatic metastases. World J Surg 1995; 19: 246-51.

  41. Sanz-Altamira PM, Spence LD, Huberman MS, Posner MR, Steele G Jr, Perry LJ, et al. Selective chemoembolization in the management of hepatic metastases in refractory colorectal carcinoma: a phase II trial. Dis Colon Rectum 1997; 40: 770-5.

  42. Ravikumar TS, Kane R, Cady B, Jenkins RL, McDermott W, Onik G, et al. Hepatic cryosurgery with intraoperative ultrasound monitoring for metastatic colon carcinoma. Arch Surg 1987; 122: 403-9.

  43. Seifert JK, Morris DL. Prognostic factors after cryotherapy for hepatic metastases from colorectal cancer. Ann Surg 1998; 228: 201-8.

  44. Preketes AP, Caplehorn JRM, King J, Clingan PR, Ross WB, Morris OL. Effect of hepatic artery chemotherapy on survival of patients with hepatic metastases from colorectal carcinoma treated with cryotherapy. World J Surg 1995; 19: 768-71; comment 771.

  45. Ravikumar TS. Interstitial therapies for liver tumors. Surg Oncol Clin N Am 1995; 5: 365-78.

  46. Amin Z, Donald JJ, Masters A, Kant R, Steger AC, Brown SG, et al. Hepatic metastases: interstitial laser photocoagulation with real-time US monitoring and dynamic CT evaluation of treatment. Radiology 1993; 187: 339-47.

  47. Nolsoe CP, Torp Pedersen S, Burcharth F, Horn T, Pedersen S, Christensen NEH, et al. Interstitial hyperthermia of colorectal liver metastases with an US-guided Nd-YAG laser with a diffuser tip: a pilot clinical study. Radiology 1993; 187: 333-7.




2020     |     www.medigraphic.com