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Colorectal cancer: managing distant metastases
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|September 1, 1985
Summary
Early diagnosis and surgical removal offer the best colorectal cancer cure. Surgical resection of liver or lung metastases can improve survival, while chemotherapy manages extensive disease.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Colorectal cancer frequently metastasizes, primarily to the liver.
- Metastatic disease impacts approximately 50% of patients.
- Early diagnosis and complete primary tumor excision are crucial for cure.
Purpose of the Study:
- To review treatment strategies for colorectal cancer with metastatic disease.
- To outline the role of surgery and chemotherapy in managing metastases.
- To emphasize the importance of palliative care.
Main Methods:
- Literature review of treatment modalities for colorectal cancer metastasis.
- Analysis of surgical resection outcomes for liver and lung metastases.
- Evaluation of chemotherapy efficacy, including hepatic artery infusion.
Main Results:
- Surgical resection of solitary liver metastases offers a 5-year survival of at least 25%.
- Resection may benefit patients with limited, unilobar multiple liver metastases.
- Hepatic artery infusion chemotherapy shows high response rates, but survival benefit is unclear.
- Systemic chemotherapy for multiorgan involvement yields generally poor results.
Conclusions:
- Complete surgical excision of primary and metastatic disease offers the best chance for cure.
- Metastasectomy, particularly for liver and lung, is a viable treatment option for select patients.
- Palliative care, encompassing anticancer treatments and supportive care, is essential.