ASO Author Reflections: The Liver-First Approach: A New Standard for Patients with Multiple Bilobar Colorectal Metastases?

Felice Giuliante, Luca Viganò, Agostino Maria De Rose, René Adam

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

The best surgical strategy for patients with colorectal cancer and synchronous liver metastases is a matter of endless debate. Technical and oncological issues must be considered but have often been confounded. In 2006, Mentha et al.1 proposed an innovative and convincing oncosurgical approach, whereby they reversed the strategy, focusing attention on the prognostically most relevant target, i.e. the liver. Even if appealing, the liver-first approach struggled to find its role and failed to demonstrate a benefit, except for the inclusion of chemoradiotherapy in the treatment schedule of patients with locally advanced rectal tumors. The proposers themselves reported non-inferiority (and not superiority) of the reverse strategy in comparison with the standard primary-first approach.2 A recent network meta-analysis ranked the liver-first approach as the best treatment option for its relative efficacy based on 5-year overall survival outcomes,3 but the evidence is too weak to impact current clinical practice.
Lingua originaleEnglish
pagine (da-a)8209-8210
Numero di pagine2
RivistaAnnals of Surgical Oncology
Volume28
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Colorectal Neoplasms
  • Hepatectomy
  • Humans
  • Liver Neoplasms

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