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Hépato-Gastro & Oncologie Digestive

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Metastatic colorectal cancers: A step-up strategy in a palliative setting? Volume 26, issue 1, Janvier 2019

Authors
1 Centre Hospitalier Régional La Source, Service d’hépato-gastroentérologie et oncologie digestive, 14 avenue de l’Hôpital, BP 86709, F 45709 Orléans cedex 2
2 CHU Dijon, Service d’hépato-gastroenterologie et oncologie digestive, Université Bourgogne Franche-Comté, INSERM LNC UMR1231, 21000 Dijon
* Correspondance

Some patients will not be fit to surgical resection of their colorectal cancer and its metastases, even after an induction chemotherapy, for example if numerous metastases are located in several sites or in almost all hepatic segments. Colorectal cancers usually concern patients more than 65 years old, with co-morbidities especially cardio-vascular ones. The aim of the oncological treatment is then not to achieve a tumor response but the longest survival with the lowest toxicity rate. A step-up strategy allows avoiding the adverse effects during the first line of treatment. In a selected population, convergent results of academic trials showed the absence of deleterious effect in terms of survival with this step-up strategy.

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