Colorectal Liver Metastasis

This video with 3 actual cases of colorectal cancer-related liver metastasis discusses the multimodal management of metastatic liver cancer from colorectal cancer and brings across the vast experience of Dr. Prasad Wagle, senior consultant liver and pancreatic surgeon at Lilavati hospital, Mumbai, Maharashtra as well as Asian Cancer Institute, Cumbala Hill Hospital, Mumbai, Maharashtra.

The talk gives an understanding of liver limited metastasis from metastatic colon cancer as well as rectal cancer and gives an overview of its management. It answers the question of what is synchronous liver metastasis and what is metachronous liver metastasis. It defines resectable or operable colorectal liver metastasis or CRLM and shares recent updates in rectal cancer management for Stage IV disease. The video then describes the various surgical options for the management of liver metastasis and describes each of them in brief and to the point. The key point is that surgery improves survival in these patients.

Synchronous liver metastasis is then discussed. Liver resectability in metastatic colorectal cancer is difficult to ascertain and the criteria are clearly described practically in this talk. The role of two-staged hepatectomy, ALPPS, portal vein embolization, transarterial chemoembolization or TACE and Transarterial radioembolization or TARE, and radiofrequency ablation or RFA and microwave ablation or MWA are also discussed.

The video is a masterclass on surgical management of colorectal liver metastasis and gives a very clear message that stage IV colon or rectal cancer can be treated and survivals achieved by appropriate sequencing of treatment. The dilemma of bowel first versus liver first versus simultaneous approach in synchronous disease is also addressed.

The talk then talks of prognostic scores such as the Fong score, Memorial Sloan Kettering cancer centre scoring system, the MSKCC score, and the modified clinical score. The interesting topic of whether to operate disappearing liver metastasis or not is next discussed and this is a very important part of the talk on CRLM. So, DO have a look at the video and I am sure it will be a treat for all of you.