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Background <p>Colorectal cancer is one of the most common malignancies worldwide. A&#xa0;significant proportion of patients develop liver metastases during disease progression.</p> Objective <p>The aim of this study is to present the current surgical and pharmacological treatment options as well as local ablative radiotherapy techniques for oligometastatic colorectal cancer.</p> Results and conclusion <p>Surgery remains the primary treatment modality for colorectal liver metastases. Preoperative conditioning strategies, such as liver venous deprivation, portal vein embolization, and the ALPPS procedure (associating liver partition and portal vein ligation for staged hepatectomy), can facilitate achievement of R0 resection. Liver transplantation within the framework of the LIVER T(W)O HEAL study represents a&#xa0;promising curative treatment option. Perioperative systemic therapy is not standardized and should be determined on an individual basis within an interdisciplinary tumor board. Neoadjuvant therapies aim to reduce metastatic burden and may enable secondary resectability. In cases of unresectable liver metastases, local ablative radiotherapy expands the therapeutic spectrum. Advanced techniques such as stereotactic body radiotherapy and brachytherapy improve local tumor control and contribute to the long-term prognosis and patient quality of life. Overall, treatment strategies should be individualized and based on an interdisciplinary approach. Combinations of surgery, systemic therapy, and local ablative procedures represent promising therapeutic concepts and are the focus of ongoing clinical research.</p>

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Multimodale Therapiemöglichkeiten beim oligometastasierten kolorektalen Karzinom

  • 期刊论文

  • 发表日期：

    2025年4月7日

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  • Laura Schwenk,
  • Falk Rauchfuss,
  • Lara Caglayan,
  • Eleni Gkika,
  • Stefanie Corradini,
  • Thomas Ernst,
  • Utz Settmacher

摘要

Background

Colorectal cancer is one of the most common malignancies worldwide. A significant proportion of patients develop liver metastases during disease progression.

Objective

The aim of this study is to present the current surgical and pharmacological treatment options as well as local ablative radiotherapy techniques for oligometastatic colorectal cancer.

Results and conclusion

Surgery remains the primary treatment modality for colorectal liver metastases. Preoperative conditioning strategies, such as liver venous deprivation, portal vein embolization, and the ALPPS procedure (associating liver partition and portal vein ligation for staged hepatectomy), can facilitate achievement of R0 resection. Liver transplantation within the framework of the LIVER T(W)O HEAL study represents a promising curative treatment option. Perioperative systemic therapy is not standardized and should be determined on an individual basis within an interdisciplinary tumor board. Neoadjuvant therapies aim to reduce metastatic burden and may enable secondary resectability. In cases of unresectable liver metastases, local ablative radiotherapy expands the therapeutic spectrum. Advanced techniques such as stereotactic body radiotherapy and brachytherapy improve local tumor control and contribute to the long-term prognosis and patient quality of life. Overall, treatment strategies should be individualized and based on an interdisciplinary approach. Combinations of surgery, systemic therapy, and local ablative procedures represent promising therapeutic concepts and are the focus of ongoing clinical research.