1008 New surgical and combined modality approaches to colorectal liver metastases

Abstract

To improve the results of surgery in the treatment of liver metastases the following strategies are under investigation:<ul><li>1.Adjuvant systemic and regional chemotherapy to eliminate micrometastases</li><li>2.Preoperative intraarterial chemotherapy to improve resectability and to avoid intraoperative tumour cell propagation</li><li>3.Intraoperative sonography as well to improve the definition of adequate resection margins as to detect additional metastases</li><li>4.Radio-Immuno-Guided Surgery (RIGS) or Laser-Induced-Fluorescence-Diagnosis (LIFD) to improve the intraoperative detection of micrometastases and of extrahepatic tumour manifestations</li><li>5.Laser-Induced-Hyperthermia (LIT) or cryotherapy to treat irresectable metastases</li><li>6.In situ or ex situ liver perfusion (work bench technique) to treat multiple liver metastases</li><li>7.Tumour cell vaccination to treat colorectal micrometastases.</li></ul> These strategies will have to be approved in further, carefully planned clinical investigations. There is hope that at least some of these concepts will add to a stepwise improvement of the results of surgical therapy in patients with colorectal liver metastases.