Colorectal cancer metastasis treatment: Difference between revisions
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==Overview== | ==Overview== | ||
When colorectal cancer | When colorectal cancer metastasizes there will be a different approach than with a localized [[tumor]]. | ||
==Metastasis== | ==Metastasis== | ||
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*Resectability of hepatic liver metastasis is determined using preoperative imaging studies (Ct or MRI), [[intraoperative ultrasound]], and by direct [[palpation]] and visualization during resection | *Resectability of hepatic liver metastasis is determined using preoperative imaging studies (Ct or MRI), [[intraoperative ultrasound]], and by direct [[palpation]] and visualization during resection | ||
*[[Lesions]] confined to the [[right lobe]] are amenable to en bloc removal with a right [[hepatectomy]] surgery | *[[Lesions]] confined to the [[right lobe]] are amenable to en bloc removal with a right [[hepatectomy]] surgery | ||
*Smaller lesions of the central or left liver lobe may sometimes be resected in anatomic "segments", while large lesions of left hepatic lobe are resected by hepatic trisegmentectomy *Treatment of lesions by smaller, | *Smaller lesions of the central or left liver lobe may sometimes be resected in anatomic "segments", while large lesions of left hepatic lobe are resected by hepatic trisegmentectomy *Treatment of lesions by smaller, non-anatomic "wedge" resections, are associated with higher recurrence rates | ||
*Some lesions which are not initially amenable to surgical resection may become candidates if they have significant responses to preoperative [[chemotherapy]] regimens | *Some lesions which are not initially amenable to surgical resection may become candidates if they have significant responses to preoperative [[chemotherapy]] regimens | ||
*Lesions which are not amenable to surgical resection for cure can be treated with modalities including radio-frequency ablation (RFA), [[cryoablation]], and [[chemoembolization]] | *Lesions which are not amenable to surgical resection for cure can be treated with modalities including radio-frequency ablation (RFA), [[cryoablation]], and [[chemoembolization]] | ||
Revision as of 20:03, 15 July 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.; Elliot B. Tapper, M.D.
Overview
When colorectal cancer metastasizes there will be a different approach than with a localized tumor.
Metastasis
Treatment of colorectal cancer metastasis to the liver
- According to the American Cancer Society statistics in 2006, [2]greater than 20% of patients present with metastatic (stage IV) colorectal cancer at the time of diagnosis, and up to 25% of this group will have isolated heaptic metastasis that is potentially resectable
- Resectability of hepatic liver metastasis is determined using preoperative imaging studies (Ct or MRI), intraoperative ultrasound, and by direct palpation and visualization during resection
- Lesions confined to the right lobe are amenable to en bloc removal with a right hepatectomy surgery
- Smaller lesions of the central or left liver lobe may sometimes be resected in anatomic "segments", while large lesions of left hepatic lobe are resected by hepatic trisegmentectomy *Treatment of lesions by smaller, non-anatomic "wedge" resections, are associated with higher recurrence rates
- Some lesions which are not initially amenable to surgical resection may become candidates if they have significant responses to preoperative chemotherapy regimens
- Lesions which are not amenable to surgical resection for cure can be treated with modalities including radio-frequency ablation (RFA), cryoablation, and chemoembolization
- These patient may be treated in either a single surgery or in staged surgeries (with the colon tumor traditionally removed first) depending upon the fitness of the patient for prolonged surgery and the difficulty expected with the procedure with either the colon or liver resection