Resection of colorectal liver metastases: only for younger patients?

摘要

A large body of evidence supports the role of liver resection for liver-confined metastatic colorectal cancer. Although case series have calculated survival from different time points, 5-year survival approaching 60% has been reported. Some studies report patients surviving for 10 years, with these patients considered to be cured. Most patients, however, present with initially unresectable liver disease. In the past decade, conversion therapy (ie, unresectable disease becoming resectable after systemic chemotherapy) has become possible. Tandem advances in surgical technique and post-operative care have resulted in more patients becoming candidates for liver resection. The CELIM study, a randomised phase 2 trial reported in January in The Lancet Oncology, showed that the addition of cetuximabto modern systemic chemotherapy resulted in an increase in resectability of 28% (from 32% at baseline to 60% after chemotherapy).