Update and review of the multidisciplinary management of stage IV colorectal cancer with liver metastases
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Review
Update and review of the multidisciplinary management of stage IV colorectal cancer with liver metastases Sherif Raafat Zikry Abdel-Misih, Carl R Schmidt and Paul Mark Bloomston* Address: The Ohio State University/James Cancer Hospital, Columbus, Ohio 43210, USA Email: Sherif Raafat Zikry Abdel-Misih - [email protected]; Carl R Schmidt - [email protected]; Paul Mark Bloomston* - [email protected] * Corresponding author
Published: 29 September 2009 World Journal of Surgical Oncology 2009, 7:72
doi:10.1186/1477-7819-7-72
Received: 28 July 2009 Accepted: 29 September 2009
This article is available from: http://www.wjso.com/content/7/1/72 © 2009 Abdel-Misih et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The management of stage IV colorectal cancer with liver metastases has historically involved a multidisciplinary approach. In the last several decades, there have been great strides made in the therapeutic options available to treat these patients with advancements in medical, surgical, locoregional and adjunctive therapies available to patients with colorectal liver metastases(CLM). As a result, there have been improvements in patient care and survival. Naturally, the management of CLM has become increasingly complex in coordinating the various aspects of care in order to optimize patient outcomes. Review: A review of historical and up to date literature was undertaken utilizing Medline/PubMed to examine relevant topics of interest in patients with CLM including criterion for resectability, technical/surgical considerations, chemotherapy, adjunctive and locoregional therapies. This review explores the various disciplines and modalities to provide current perspectives on the various options of care for patients with CLM. Conclusion: Improvements in modern day chemotherapy as allowed clinicians to pursue a more aggressive surgical approach in the management of stage IV colorectal cancer with CLM. Additionally, locoregional and adjunctive therapies has expanded the armamentarium of treatment options available. As a result, the management of patients with CLM requires a comprehensive, multidisciplinary approach utilizing various modalities and a more aggressive approach may now be pursued in patients with stage IV colorectal cancer with CLM to achieve optimal outcomes.
Introduction Colorectal cancer(CRC) is the third most common noncutaneous malignancy in both men and women(Men Lung, Prostate; Women - Lung, Breast) [1]. Approximately 150,000 cases of colorectal cancers are diagnosed annually in the United States, 25% of which present with liver metastases [2]. In total, up to one-half will develop liver metastases. The management of colorectal liver metastases (CLM) has changed dramatically in th
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