| [ Summary ] |
There is an increasing number of metastases, resulting from colorectal cancer. The therapy for these metastases is gradually improving. Survival for five years or more is rare among patients with unresected hepatic metastases, who have received conventional systemic chemotherapy. After five years, about 30 percent of patients who have had liver resection are living. It was indicated that the prognoses for hepatic metastases in those who had liver resections depended on 1. Original colorectal cancer depth, lymph node involvement (Dukes C vs. B) and serum carcinoembryonic antigens, 2. Interval from primary operation, size of largest liver metastases and number of liver metastases (three or less vs. more than three), 3.Surgical margin (less than 10 mm vs. more than 10 mm), 4. Adjuvant chemotherapy (hepatic arterial infusion plus systemic chemotherapy having received or not). To treat suspected micrometastases in the remaining liver tissue and prevent extrahepatic spreading, a reasonable approach involves the use of a combination of regional therapy, such as hepatic arterial infusion chemotherapy, and systemic chemotherapy. In the treatment of advanced colorectal cancer two theories were considered: primary forms of cancer were seen as a localized disease, requiring surgery, and secondary forms of cancer, such as hepatic metastases must be controlled through use of surgery as a local treatment and systemic therapy when the condition is wide spread. |