John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Management of colorectal liver metastases in 2014 Volume 21, issue 7, Septembre 2014


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1 CHU de Saint-Étienne,
Hôpital Nord,
service d’hépato-gastroentérologie et d’oncologie digestive,
42055 Saint-Étienne,
2 CHRU de Lille 2,
service d’oncologie médicale,
avenue Oscar Lambret,
59037 Lille Cedex,

Due to its high incidence and its gravity, colorectal cancer is an important health care problem in most developed countries (more than 200.000 deaths each year in Europe). Major therapeutic advance enable multidisciplinary optimized and tailored strategies which substantially improve outcome for patients. Overall survival was 6 months in the 90's and is now over 24 months thanks to combined chemotherapies and biotherapies. The handling of hepatic metastases is a major aim because 8 out of 10 patients are concerned. Resectability of these metastases has improved in the last 10 years. Five-year survival of these patients is 50%. At the beginning of the disease, prognostic scores allow to adapt the best therapeutic strategies. The number of metastatic sites, the lactate deshydrogenase rate, alkaline phosphatase, CEA, and performance status are the main factors to define good, intermediate or bad prognostic groups of patients. Biotherapies with biologic markers (KRAS, NRAS) or maintenance antiangiogenic strategies ameliorate the outcome for all groups of patients. In the future, these results will no doubt improve thanks to ever more frequent therapeutic innovations and the development of tailored strategies.