Cytoreduction for colorectal metastases: liver, lung, peritoneum, lymph nodes, bone, brain. When does it palliate, prolong survival, and potentially cure?

Curr Probl Surg. 2018 Sep;55(9):330-379. doi: 10.1067/j.cpsurg.2018.08.004. Epub 2018 Oct 4.

Abstract

Colorectal cancer commonly metastasizes. The liver is the most frequent site of metastases and dominates the length of survival for this disease. As surgical and systemic therapies have become accepted and now are proven to be potentially curative, other sites of metastases have become more clinically relevant in terms of clinical symptoms and influence on survival. Treatment of extrahepatic metastases by surgical and ablative procedures is increasingly accepted and is proving to be effective at palliating symptoms, as well as life prolonging. In this review, we will first summarize key issues with metastatic colorectal cancer to the liver and available treatments. We will then discuss surgical and ablative treatments of other sites of disease including lung, lymph nodes, peritoneum, bone, and brain. Best available evidence for treatment strategies will be presented as well as potential new directions.

Publication types

  • Review

MeSH terms

  • Bone Neoplasms / mortality
  • Bone Neoplasms / secondary*
  • Brain Neoplasms / mortality
  • Brain Neoplasms / secondary*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / therapy
  • Cytoreduction Surgical Procedures* / mortality
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / secondary*
  • Lymphatic Metastasis / pathology*
  • Palliative Care
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / secondary*
  • Prognosis
  • Survival Rate