Abstract

DAVILA, Diego; PALACIOS, Óscar  and  NARANJO, Camilo. Hepatic metástases in colorectal cancer: therapeutic strategies and current recommendations. rev. colomb. cir. [online]. 2017, vol.32, n.4, pp.304-318. ISSN 2011-7582.  https://doi.org/10.30944/20117582.39.

Metastatic colorectal cancer in the liver is a frequent pathology that until a few years ago was considered only for palliative management. However, with the recent advent of new techniques and advances to improve the resectability of such lesions and the new schemes of chemotherapy, oncological resection of these lesions can be performed, extracting all macroscopic tumor and achieving a positive impact on patient's survival. Multiple schemes have been postulated for the management of synchronous lesions in order to improve patient survival, although there is no consensus about which is the best scheme in these cases; it seems that the most important factor is to complete successfully the proposed scheme. In general, the current trend is to perform the liver resection first unless the primary tumor is symptomatic, in which case a colectomy should be performed as the initial approach. Simultaneous resections are part of the therapeutic arsenal in these patients. Many groups suggest not to associate a low rectal resection with a major hepatectomy. On the other hand, metachronic lesions should be resected based on their size and the possibility of resection should be considered once the diagnosis has been made. It is important to take into account that even if a complete resection of the tumor and R0 margins are achieved, recurrences are frequent because microscopic tumor dissemination is already present; therefore, the addition of chemotherapy regimens should be mandatory to Improve the oncological prognosis of these patients.

Keywords : Neoplasms; liver; colonic neoplasms; neoplasm metastasis; neoplasms; second primary; hepatectomy; clinical protocols; survival.

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