Synchronous Colorectal Cancer

Synchronous colorectal cancer with liver metastasis (SCLM) represents a challenge for both surgeons and oncologists once 15-25% of patients diagnosed with colon cancer present metastatic liver disease . Despite a worse prognosis when compared with metachronous metastases, surgical resection of all liver disease remains the only curative treatment of patients with SCLM with 5y survival ranging from 22-58%. Simultaneous approach (SA) involves the resection of the primary tumor and the liver metastasis (with or with neoadjuvant chemotherapy) and contra pose to the classical colon first approach (CA). Reversal approach (RA) in which the metastatic liver disease is resected first is another therapeutic option that could be used in a minority of cases presenting with rectal cancer in which the amount of liver disease precludes a safe and margin free resection. However the optimal surgical management of patients with SCLM remains controversial.When facing the scenario of synchronic liver only metastasis of colorectal tumor, from the liver perspective, three main scenarios can be seen: 1-. unresectable, 2-potentialy resectable and 3-resectable liver disease.

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Last date updated on September, 2024