FIRST BRAZILIAN CONSENSUS ON MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 1: PRE-TREATMENT EVALUATION

Aim: In this module, was contextualized the clinical situations and parameterized epidemiological data and results of the various treatment modalities established.

Method: Was realized deep discussion on detecting and staging metastatic colorectal cancer, as well as employment of imaging methods in the evaluation of response to instituted systemic therapy.

Results: The next step was based on the definition of which patients would have their metastases considered resectable and how to expand the amount of patients elegible for modalities with curative intent.

Conclusion: Were presented clinical, pathological and molecular prognostic factors, validated to be taken into account in clinical practice.

Citing Articles

The impact of multivisceral liver resection on short- and long-term outcomes of patients with colorectal liver metastasis: A systematic review and meta-analysis.

Junior S, Tustumi F, de Paiva Magalhaes D, Jeismann V, Fonseca G, Pirola Kruger J Clinics (Sao Paulo). 2022; 77:100099.

PMID: 36122500 PMC: 9489954. DOI: 10.1016/j.clinsp.2022.100099.

PRIMARY TUMOR LYMPHOVASCULAR INVASION NEGATIVELY AFFECTS SURVIVAL AFTER COLORECTAL LIVER METASTASIS RESECTION?.

Campanati R, Sancio J, Sucena L, Sanches M, Resende V Arq Bras Cir Dig. 2021; 34(1):e1578.

PMID: 34133525 PMC: 8195463. DOI: 10.1590/0102-672020210001e1578.

Feasibility of Right Upper Transversal Hepatectomy in the Absence of an Inferior Right Hepatic Vein: New Insights regarding This Complex Procedure.

Makdissi F, Pirola Kruger J, Jeismann V, Herman P Case Rep Surg. 2021; 2021:6668269.

PMID: 33747594 PMC: 7960046. DOI: 10.1155/2021/6668269.

Current state of the art imaging approaches for colorectal liver metastasis.

Hazhirkarzar B, Khoshpouri P, Shaghaghi M, Ghasabeh M, Pawlik T, Kamel I Hepatobiliary Surg Nutr. 2020; 9(1):35-48.

PMID: 32140477 PMC: 7026783. DOI: 10.21037/hbsn.2019.05.11.

BRAZILIAN CONSENSUS FOR MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 3: CONTROVERSIES AND UNRESECTABLE METASTASES.

Torres O, Marques M, Santos F, de Farias I, Coutinho A, de Oliveira C Arq Bras Cir Dig. 2016; 29(3):173-179.

PMID: 27759781 PMC: 5074669. DOI: 10.1590/0102-6720201600030011.

References

Fong Y, Cohen A, Fortner J, Enker W, Turnbull A, Coit D . Liver resection for colorectal metastases. J Clin Oncol. 1997; 15(3):938-46. DOI: 10.1200/JCO.1997.15.3.938. View

Kune G, Kune S, Field B, White R, Brough W, Schellenberger R . Survival in patients with large-bowel cancer. A population-based investigation from the Melbourne Colorectal Cancer Study. Dis Colon Rectum. 1990; 33(11):938-46. DOI: 10.1007/BF02139103. View

Kopetz S, Chang G, Overman M, Eng C, Sargent D, Larson D . Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol. 2009; 27(22):3677-83. PMC: 2720081. DOI: 10.1200/JCO.2008.20.5278. View

Are C, Gonen M, Zazzali K, DeMatteo R, Jarnagin W, Fong Y . The impact of margins on outcome after hepatic resection for colorectal metastasis. Ann Surg. 2007; 246(2):295-300. PMC: 1933562. DOI: 10.1097/SLA.0b013e31811ea962. View

Zech C, Korpraphong P, Huppertz A, Denecke T, Kim M, Tanomkiat W . Randomized multicentre trial of gadoxetic acid-enhanced MRI versus conventional MRI or CT in the staging of colorectal cancer liver metastases. Br J Surg. 2014; 101(6):613-21. PMC: 4312911. DOI: 10.1002/bjs.9465. View

Hamady Z, Lodge J, Welsh F, Toogood G, White A, John T . One-millimeter cancer-free margin is curative for colorectal liver metastases: a propensity score case-match approach. Ann Surg. 2013; 259(3):543-8. DOI: 10.1097/SLA.0b013e3182902b6e. View

Figueras J, Burdio F, Ramos E, Torras J, Llado L, Lopez-Ben S . Effect of subcentimeter nonpositive resection margin on hepatic recurrence in patients undergoing hepatectomy for colorectal liver metastases. Evidences from 663 liver resections. Ann Oncol. 2007; 18(7):1190-5. DOI: 10.1093/annonc/mdm106. View

Matsuda A, Matsumoto S, Seya T, Matsutani T, Kishi T, Yokoi K . Does postoperative complication have a negative impact on long-term outcomes following hepatic resection for colorectal liver metastasis?: a meta-analysis. Ann Surg Oncol. 2013; 20(8):2485-92. DOI: 10.1245/s10434-013-2972-z. View

Mantke R, Schmidt U, Wolff S, Kube R, Lippert H . Incidence of synchronous liver metastases in patients with colorectal cancer in relationship to clinico-pathologic characteristics. Results of a German prospective multicentre observational study. Eur J Surg Oncol. 2012; 38(3):259-65. DOI: 10.1016/j.ejso.2011.12.013. View

10.

Dello S, Stoot J, van Stiphout R, Bloemen J, Wigmore S, Dejong C . Prospective volumetric assessment of the liver on a personal computer by nonradiologists prior to partial hepatectomy. World J Surg. 2010; 35(2):386-92. PMC: 3017311. DOI: 10.1007/s00268-010-0877-6. View

11.

Jones R, Vauthey J, Adam R, Rees M, Berry D, Jackson R . Effect of specialist decision-making on treatment strategies for colorectal liver metastases. Br J Surg. 2012; 99(9):1263-9. DOI: 10.1002/bjs.8835. View

12.

Coimbra F, Pires T, da Costa Junior W, Diniz A, Ribeiro H . Advances in surgical treatment of colorectal liver metastases. Rev Assoc Med Bras (1992). 2011; 57(2):220-7. DOI: 10.1590/s0104-42302011000200022. View

13.

Konopke R, Kersting S, Bergert H, Bloomenthal A, Gastmeier J, Saeger H . Contrast-enhanced ultrasonography to detect liver metastases : a prospective trial to compare transcutaneous unenhanced and contrast-enhanced ultrasonography in patients undergoing laparotomy. Int J Colorectal Dis. 2006; 22(2):201-7. DOI: 10.1007/s00384-006-0134-5. View

14.

Floriani I, Torri V, Rulli E, Garavaglia D, Compagnoni A, Salvolini L . Performance of imaging modalities in diagnosis of liver metastases from colorectal cancer: a systematic review and meta-analysis. J Magn Reson Imaging. 2009; 31(1):19-31. DOI: 10.1002/jmri.22010. View

15.

Ribero D, Chun Y, Vauthey J . Standardized liver volumetry for portal vein embolization. Semin Intervent Radiol. 2011; 25(2):104-9. PMC: 3036478. DOI: 10.1055/s-2008-1076681. View

16.

Zavadsky K, Lee Y . Liver metastases from colorectal carcinoma: incidence, resectability, and survival results. Am Surg. 1994; 60(12):929-33. View

17.

Koh D, Collins D, Wallace T, Chau I, Riddell A . Combining diffusion-weighted MRI with Gd-EOB-DTPA-enhanced MRI improves the detection of colorectal liver metastases. Br J Radiol. 2011; 85(1015):980-9. PMC: 3474082. DOI: 10.1259/bjr/91771639. View

18.

Pawlik T, Schulick R, Choti M . Expanding criteria for resectability of colorectal liver metastases. Oncologist. 2008; 13(1):51-64. DOI: 10.1634/theoncologist.2007-0142. View

19.

Sheth K, Clary B . Management of hepatic metastases from colorectal cancer. Clin Colon Rectal Surg. 2009; 18(3):215-23. PMC: 2780092. DOI: 10.1055/s-2005-916282. View

20.

Folprecht G, Gruenberger T, Bechstein W, Raab H, Lordick F, Hartmann J . Tumour response and secondary resectability of colorectal liver metastases following neoadjuvant chemotherapy with cetuximab: the CELIM randomised phase 2 trial. Lancet Oncol. 2009; 11(1):38-47. DOI: 10.1016/S1470-2045(09)70330-4. View