Modern possibilities of liver surgery for colorectal cancer metastases.

Abstract

In recent years there has been a significant improvement in the approaches of the treatment of patients with liver metastases of colorectal cancer. This is caused by improved diagnostics modalities. Modern possibilities of CT and MRI in combination with liver-specific contrast agents enable to localize tumor very precise, evaluate its location relative to blood vessels and other anatomic structures and, thus, carefully plan surgery. Ultrasound with contrast agents can add some important information.
Multidisciplinary approach in treatment.
Current chemotherapeutic drugs are becoming more specific, thereby increasing their effectiveness. Currently used regimens can be effective in about 60% of patients. Individual approach to chemotherapy using mutational analysis in some cases, makes possible to estimate beforehand efficacy and thus reduce the probability of treatment failure, followed by a high load for the patient. A good example in this case can serve K-Ras gene mutation that caused ineffectiveness therapy with Cetuximab. Conversely, wild forms of K-Ras oncogene allow to carry out this kind of treatment. Advances in chemotherapy make possible to perform complete removal of the tumor in approximately 20% of patients with primary inoperable tumors.