Surgical treatment of colo rectal liver metastases
Download as PPTX, PDF0 likes270 views
The document discusses guidelines for resection of liver metastases from colorectal cancer. It states that the aim of liver resection is to remove all visible cancer while leaving enough healthy liver tissue. Patients with solitary, multiple, or scattered tumors may be candidates for resection if the primary colorectal cancer has been treated. The surgeon should ensure clear margins and leave a minimum of one third of the standard liver volume to minimize risk of liver failure. Overall survival rates are improved with resection compared to chemotherapy alone.
Surgical treatment of colo rectal liver metastases
- 1. Gian Luca Grazi Hepato-Biliary-Pancreatic Surgery National Cancer Institute Regina Elena Rome Liver Metastases from ColoRectal Cancer
- 2. Liver Metastases from ColoRectal Cancer • The aim of liver resection (resectability) is to remove all macroscopic disease with clear (negative) margins and leave sufficient functioning liver. (Category of evidence II; strength of recommendation B) • Patients with solitary, multiple, and bilobar disease who have had radical treatment of the primary colorectal cancer are candidates for liver resection. (Category of evidence III; strength of recommendation C) • The ability to achieve clear margins (R0 resection) should be determined by the radiologist and surgeon in the regional hepatobiliary unit. (Category of evidence III; strength of recommendation C) • The surgeon should define the acceptable residual functioning volume, approximately one third of the standard liver volume, or the equivalent of a minimum of two segments. (Category of evidence III; strength of recommendation C) Guidelines for resection of colorectal cancer liver metastases Garden OJ, Gut 2006;55 (Suppl III): iii1–iii8
- 3. Liver Metastases from ColoRectal Cancer Chemotherapy and cure 85 (5%) 5 years survivors 26 (1%) NED without surgery Cure < 1% Sanoff HK, J Clin Oncol 2008, 26:5721-5727
- 4. Liver Metastases from ColoRectal Cancer Cucchetti A, Ann Surg Oncol 2014, epub
- 5. Liver Metastases from ColoRectal Cancer Cucchetti A, Ann Surg Oncol 2014, epub
- 6. Liver Metastases from ColoRectal Cancer Jones RP, Br J Surg 2012; 99: 1263–1269
- 7. Liver Metastases from ColoRectal Cancer • 200 Medical Oncologists with > 5 years of practice (overall 80% response rate) • CT scans reviewed by 3 hepatic surgeons who conducted more than 50 hepatectomies and currently performing CRLM surgery as a major component of their practice, defined resectability
- 8. Liver Metastases from ColoRectal Cancer HCC 131 Intrahepatic Cholangiocarcinoma 45 Metastases 259 Perihilar Cholangiocarcinoma 26 Others 70 551 Liver Resections (June 2010 – April 2017) Gallbladder 20
- 9. Liver Metastases from ColoRectal Cancer Overall Survival after Liver Resections for Colo Rectal Metastases
- 10. Liver Metastases from ColoRectal Cancer Overall Survival after Liver Resections for Colo Rectal Metastases by Tumor Diameter
- 11. Liver Metastases from ColoRectal Cancer
- 12. Liver Metastases from ColoRectal Cancer
- 13. Liver Metastases from ColoRectal Cancer
- 14. Liver Metastases from ColoRectal Cancer
- 15. Liver Metastases from ColoRectal Cancer
- 16. Liver Metastases from ColoRectal Cancer
- 17. Liver Metastases from ColoRectal Cancer
- 18. Gian Luca Grazi Hepato Biliary Pancreatic Surgery National Cancer Institute “Regina Elena”, Rome, Italy [email protected] www.chirurgiadelfegato.it Liver Metastases from ColoRectal Cancer