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- Title
Management of liver metastases in Latin America.
- Authors
Uribe, Mario; Benedetti, Vincenzo; Torres-Quevedo, Rodrigo; Lim, Fiona; Wan, Bo Angela; Silva, Maurício F.
- Abstract
Liver is one of the organs most frequently affected by tumor metastasis, particularly colorectal cancer, one of the most common neoplasms in the world. Liver metastases represent an important prognostic and therapeutic factor in these patients. Surgery has been considered the only potentially curative strategy, and also potentially impacts survival in some disease entities like neuroendocrine tumors and gastrointestinal stromal tumours. However, its application is limited by the advanced state of the disease at time of diagnosis. The objective of this review is to describe current evidence about the resection and ablative techniques available. Complete resection at both macroscopic and microscopic levels (R0 resection) is the main objective of metastasectomy. Resectability criteria have expanded lately. Perioperative chemotherapy impacts diseasefree survival and overall-survival, although its evidence is limited. Ablative treatments are useful in patients who are not candidates for surgery. Techniques that aim at increasing hepatic reserve have shown promising preliminary results but have not yet been clinically validated. Liver transplantation has resurged as a possible therapeutic option in countries with a high rate of organ donation. The published Latin American series are concordant with the global experience, but it is limited to small and descriptive studies. Therefore, it is necessary to carry out new clinical trials to standardize the therapeutic options in patients with this relevant pathology.
- Subjects
LATIN America; CANCER chemotherapy; HEPATECTOMY; LIVER transplantation; LIVER tumors; METASTASIS; SYSTEMATIC reviews; ABLATION techniques
- Publication
Journal of Pain Management, 2019, Vol 12, Issue 4, p291
- ISSN
1939-5914
- Publication type
Article