Oncologic aspects of the decision-making process for surgical approach for colorectal liver metastases progressing during chemotherapy

作     者：Raphael L C Araujo Camila G C Y Carvalho Carlos T Maeda Jean Michel Milani Diogo G Bugano Pedro Henrique Z de Moraes Marcelo M Linhares 

作者机构：Department of SurgeryUniversidade Federal de São PauloSão Paulo 04024-002Brazil Department of OncologyHospital Israelita Albert EinsteinSão Paulo 05652-900Brazil Department of Surgical OncologyHospital e Maternidade Brasil Rede D'Or São LuizSanto André09030-590São PauloBrazil 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2022年第14卷第9期

页      面：877-886页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Colorectal liver metastases Oncology Disease progression Surgery Liver resection Hepatectomy 

摘      要：Colorectal cancer represents the third most diagnosed malignancy in the *** liver is the main site of metastatic disease,affected in 30%of patients with newly diagnosed *** resection is considered the only potentially curative treatment for colorectal liver metastasis(CRLM),with a 5-year survival rate ranging from 35%to 58%.However,up to 80%of patients have initially unresectable disease,due to extrahepatic disease or bilobar multiple liver *** availability of increasingly effective systemic chemotherapy has contributed to converting patients with initially unresectable liver metastases to resectable disease,improving long-term outcomes,and accessing tumor *** recent years,response to preoperative systemic chemotherapy before liver resection has been established as a major prognostic *** studies have demonstrated that patients with regression of hepatic metastases while on chemotherapy have improved outcomes when compared to patients with stabilization or progression of the *** if disease progression during chemotherapy represents an independent negative prognostic factor,some patients may still benefit from surgery,given the role of this modality as the main treatment with curative intent for patients with *** selected cases,based on size,the number of lesions,and tumor markers,surgery may be offered despite the less favorable prognosis and as an option for non-chemo responders.