Disappearing colorectal liver metastases: Strategies for the management of patients achieving a radiographic complete response after systemic chemotherapy

J Surg Oncol. 2020 Apr;121(5):848-856. doi: 10.1002/jso.25784. Epub 2019 Nov 26.

Abstract

The mainstays of treatment for colorectal liver metastases (CRLMs) are surgery and chemotherapy. Chemotherapeutic benefits of tumor shrinkage and systemic control of micrometastases are in part counterbalanced by chemotoxicity that can modify the liver parenchyma, jeopardizing the detection of CRLM. This review addresses the clinical decision-making process in the context of radiographic and pathologic responses, the preoperative imaging workup, and the approaches to the liver for CRLM, which disappear after systemic chemotherapy.

Keywords: cancer; chemotherapy; colorectal liver metastases; hepatectomy; missing metastases.

Publication types

  • Systematic Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • Clinical Decision-Making
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / therapy*
  • Neoadjuvant Therapy