Manejo de las metástasis hepáticas de origen colorrectal

TRADUCCIÓN
Resumen(en)

Colorectal cancer (CRC) is one of the most common malignant neoplasms and responsible for a large share of the mortality rate. Around 140 000 new cases of CRC are estimated to be diagnosed in the United States every year and about 58 000 of them die each year from this cause. In Andalusia, CRC is the second leading cause of cancer death after lung cancer in men and breast cancer in women, this ranking remaining stable since 1975. This cancer is more common in elderly population, with a peak incidence in the seventh decade of life. Only 5% of CRCs appear in people younger than 40 and over 70% of them originate from sporadic adenomatous polyps.

Liver metastases of colorectal cancer (LMCC) appear in 15-25% of cases at the time of diagnosis of primary tumor, while in 25-50% of cases they appear metachronously, especially in the next 3 years after the excision of the primary disease.

With the data available today we can assure that the only real chance of long-term survival of patients with LMCC relies on achieving the complete elimination of them through excision.

Chemotherapy or local destruction treatments should be considered complementary to surgery or an alternative to it when surgery is not possible, but not potentially curative options. The role of surgery is a subject closed to debate, since Wilson and Adson showed in 1976 a survival improvement in patients with LMCC that underwent resection compared to those who were left to their natural course, either in those with only liver injuries as in those with multiple metastases.