Importance of Response to Neoadjuvant Therapy in Patients With Liver-Limited mCRC When the Intent Is Resection and/or Ablation

• Published in: Clinical colorectal cancer Vol. 12; no. 4; pp. 223 - 232
• Main Author: Wagman, Lawrence D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2013
• Subjects: Antineoplastic Agents - therapeutic use; Biochemotherapy; Colorectal cancer; Gastroenterology and Hepatology; Hematology, Oncology and Palliative Medicine; Hepatectomy; Humans; Liver metastases; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Neoadjuvant; Neoadjuvant Therapy - methods; Resection; Treatment Outcome; Neoadjuvant; Liver metastases; Resection; Biochemotherapy; Colorectal cancer
• ISSN: 1533-0028; 1938-0674
• DOI: 10.1016/j.clcc.2013.06.006

Abstract This review article provides an overview of treatment options for patients with liver metastases, with a focus on the importance of response rates on resectability. The inclusion of surgery provides the only potential for cure in this setting. There are several important surgical considerations for performing resections, and close communication between oncologists and surgeons is important for achieving the intended outcome. In patients with initially unresectable colorectal liver metastases, an association between tumor response rate and resection rates has been demonstrated, implying that greater response rates could increase resection rates. Neoadjuvant chemotherapy establishes expected response rates with the use of biologic agents, such as cetuximab or bevacizumab, further improving the response rate and potentially increasing the rate of resection and potential to cure the disease.