Extending the frontiers of surgical therapy for hepatic colorectal metastases: Is there a limit?

Vijay P. Khatri, Nicholas J. Petrelli, Jacques Belghiti

Research output: Contribution to journalArticle

204 Citations (Scopus)

Abstract

Hepatic resection for colorectal metastases, limited to the liver, has become the standard of care, and currently remains the only potentially curative therapy. Numerous single institutional reports have demonstrated long-term survival, and there are no other treatment options that have shown a survival plateau. However, curative resection is possible in less than 25% of patients with disease limited to the liver, which consequently translates into only 5% to 10% of the original group developing colorectal cancer. To increase the number of patients who could benefit from hepatic resection, the last decade has seen considerable effort directed towards the following areas, (1) refining prognostic factors that would improve patient selection, (2) advancements in surgical technique such as, use of intraoperative ultrasonography, controlling hemorrhage through use of vascular clamping techniques supplemented with low central venous pressure anesthesia, availability of novel devices for parenchymal transection, and controlled anatomic hepatectomy with Glissonian technique, and (3) novel approaches to permit curative hepatic resection such as, preoperative portal vein embolization for hypertrophy of future liver remnant and staged hepatic resection. This article reviews development of these innovative multidis-ciplinary modalities and the aggressive surgical approach that has been adopted to extend the frontiers of surgical therapy for colorectal hepatic metastases.

Original languageEnglish (US)
Pages (from-to)8490-8499
Number of pages10
JournalJournal of Clinical Oncology
Volume23
Issue number33
DOIs
StatePublished - 2005

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Neoplasm Metastasis
Liver
Therapeutics
Central Venous Pressure
Survival
Hepatectomy
Standard of Care
Portal Vein
Constriction
Hypertrophy
Patient Selection
Blood Vessels
Colorectal Neoplasms
Ultrasonography
Anesthesia
Hemorrhage
Equipment and Supplies

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Extending the frontiers of surgical therapy for hepatic colorectal metastases : Is there a limit? / Khatri, Vijay P.; Petrelli, Nicholas J.; Belghiti, Jacques.

In: Journal of Clinical Oncology, Vol. 23, No. 33, 2005, p. 8490-8499.

Research output: Contribution to journalArticle

Khatri, Vijay P. ; Petrelli, Nicholas J. ; Belghiti, Jacques. / Extending the frontiers of surgical therapy for hepatic colorectal metastases : Is there a limit?. In: Journal of Clinical Oncology. 2005 ; Vol. 23, No. 33. pp. 8490-8499.
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