Update on Hepatic Mets from Colo-rectal cancers (Important for AIIMS) • Liver is the most common site of mets from colo-rectal cancers • Liver metastasis is not a contra-indication for surgery in these patients. • CECT is the most frequently used modality to detect these lesions • Intra-operative USG is the most sensitive modality for these lesions • Criteria for identifying patients who can undergo metastatectomy: 1. number of lesions (less than four, in the same lobe) 2. maximum lesion dimensions (less than 5 cm) 3. absence of metastatic spreading outside the liver, 4. adequate (more than 1 cm) margin of healthy liver tissue for all resected lesions 5. an adequate liver remnant after resection • K –RAS is an independent prognostic factor in these patients • Hepatic artery infusional chemo can be used as an adjuvant treatment in these patients. • Bevacizumab (anti-VEGF antibody) and Cetuximab/ panitumumab (anti- EGFR) agents have been approved for management of these patients • CUSA (Cavitron Ultrasonic Surgical Aspirator) can be used for hepatic resection
Posted on: Sat, 26 Apr 2014 12:47:03 +0000
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