| Theme |
Diversified Modalities of Liver Metastasis Treatment |
| Title |
Strategy for Treatment of Colorectal Liver Metastases |
| Author |
Hiroyuki Yoshidome |
Department of General Surgery, Chiba University, Graduate School of Medicine |
| Author |
Fumio Kimura |
Department of General Surgery, Chiba University, Graduate School of Medicine |
| Author |
Hiroaki Shimizu |
Department of General Surgery, Chiba University, Graduate School of Medicine |
| Author |
Masayuki Ohtsuka |
Department of General Surgery, Chiba University, Graduate School of Medicine |
| Author |
Masaru Miyazaki |
Department of General Surgery, Chiba University, Graduate School of Medicine |
| [ Summary ] |
Recent progress in chemotherapy and molecular target agents has made it possible to surgically treat initially unresectable colorectal liver metastases. Our criteria for initially unresectable colorectal liver metastases included those where there would be diminished remnant liver volume due to multiple bilobar metastases or ill-located tumors, as well as simultaneous unresectable lung metastases. Of the 17 patients who had PR／SD responding to the first line chemotherapy, the 3-year overall survival rate was 70 % better than patients not treated with this modality. On the other hand, the indications for neoadjuvant chemotherapy for resectable colorectal liver metastases are still undefined. The adverse effects from neoadjuvant chemotherapy are reported to be sinusoidal dilatation induced by oxaliplatin-based chemotherapy and steatohepatitis induced by irinotecan-based chemotherapy. To avoid these unfavorable effects, the timing of liver resection for resectable colorectal liver metastases after neoadjuvant chemotherapy is required to be determined. In conclusion, surgical treatment is beneficial for patients with downstaged colorectal liver metastases by employing conversion chemotherapy. Long-term chemotherapy prior to surgery is associated with the adverse effects observed with preoperative chemotherapy, which may affect on liver function. |