Preoperative selection of patients with colorectal cancerliver metastasis for hepatic resection
Preoperative selection of patients with colorectal cancer liver metastasis for hepatic resection作者机构：Department of SurgeryCollege of MedicineKing Saud UniversityRiyadh 11461Saudi Arabia Department of SurgeryMcGill University Health CentreHepatopancreaticobiliary Research UnitMontrealQC H4A 3J1Canada Department of OncologyMcGill University Health CenterMontrealQC H4A 3J1Canada
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2016年第22卷第2期
页 面：567-581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 cancer liver metastases Liverresection Hepatectomy Patient selection Preoperativeselection
摘 要：Surgical resection of colorectal liver metastases(CRLM) has a well-documented improvement in survival. To benefit from this intervention, proper selection of patients who would be adequate surgical candidates becomes vital. A combination of imaging techniques may be utilized in the detection of the lesions. The criteria for resection are continuously evolving; currently, the requirements that need be met to undergo resection of CRLM are: the anticipation of attaining a negative margin(R0 resection), whilst maintaining an adequate functioning future liver remnant. The timing of hepatectomy in regards to resection of the primary remains controversial; before, after, or simultaneously. This depends mainly on the tumor burden and symptoms from the primary tumor. The role of chemotherapy differs according to the resectability of the liver lesion(s); no evidence of improved survival was shown in patients with resectable disease who received preoperative chemotherapy. Presence of extrahepatic disease in itself is no longer considered a reason to preclude patients from resection of their CRLM, providing limited extra-hepatic disease, although this currently is an area of active investigations. In conclusion, we review the indications, the adequate selection of patients and perioperative factors to be considered for resection of colorectal liver metastasis.
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