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Portal Vein Injection of Colorectal Cancer Organoids to Study the Liver Metastasis Stroma

Portal Vein Injection of Colorectal Cancer Organoids to Study the Liver Metastasis Stroma

Published on: September 3, 2021

Colorectal liver metastases.

Ching-Wei D Tzeng¹, Thomas A Aloia

¹Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Unit 1484, 1400 Pressler Street, Houston, TX 77030, USA.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract

|October 12, 2012

Summary

This summary is machine-generated.

Improved survival for colorectal cancer liver metastases (CLM) is achievable with modern therapies. Careful treatment sequencing and surgical evaluation are key to successful outcomes, minimizing chemotherapy-induced liver injury.

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Area of Science:

Oncology
Hepatobiliary Surgery
Medical Oncology

Background:

Modern multimodality therapy has improved 5-year survival rates for resected colorectal cancer (CRC) liver metastases (CLM) to 50-60% through multidisciplinary care and surgical advancements.
Improved outcomes are attributed to enhanced definition of resectability and technical surgical skills.

Purpose of the Study:

To outline treatment sequencing paradigms for synchronous CRC with CLM.
To discuss the impact of chemotherapy regimens on liver function and patient outcomes.
To emphasize the role of surgical evaluation in determining resectability and preventing overtreatment.

Main Methods:

Review of treatment strategies for synchronous colorectal cancer (CRC) and colorectal cancer liver metastases (CLM).
Analysis of chemotherapy regimens (FOLFOX, FOLFIRI) and their associated chemotherapy-associated liver injury (CALI).
Emphasis on cross-sectional imaging and hepatobiliary surgeon evaluation for treatment planning.

Main Results:

Synchronous CRC with CLM can be managed with colorectal-first, simultaneous, or liver-first approaches, guided by oncological and symptomatic dominance.
Oxaliplatin (FOLFOX) is linked to vascular injury, while irinotecan (FOLFIRI) can cause steatohepatitis, particularly in patients with obesity/diabetes.
Chemotherapy-associated liver injury (CALI) from irinotecan increases mortality risk, especially with extended preoperative chemotherapy durations.

Conclusions:

Hepatobiliary surgeon evaluation and high-quality imaging are crucial before chemotherapy to determine resectability and avoid overtreatment.
Liver surgeons play a vital role in treatment planning to achieve safe, curative R0 resection and prolonged survival.
Novel surgical strategies benefit even patients with extensive bilateral or synchronous disease.