Abstract
The prognosis for oligometastatic colorectal cancer has improved in recent years, mostly because of recent advances in new techniques and approaches to the treatment of oligometastases, including new surgical procedures, better systemic treatments, percutaneous ablation, and stereotactic body radiation therapy (SBRT). There are several factors to consider when deciding on the better approach for each patient: tumor factors (metachronous or synchronous metastases, RAS mutation, BRAF mutation, disease-free interval, size and number of metastases), patient factors (age, frailty, comorbidities, patient preferences), and physicians’ factors (local expertise). These advances have presented major challenges and opportunities for oncologic multidisciplinary teams to treat patients with limited liver and lung metastases from colorectal cancer with a curative intention. In this review, we describe the different treatment options in patients with limited liver and lung metastases from colorectal cancer, and the possible combination of three approaches: systemic treatment, surgery, and local ablative treatments.
Highlights
The prognosis for oligometastatic colorectal cancer has improved in recent years, mostly because of recent advances in new techniques and approaches to the treatment of oligometastases, including new surgical procedures, better systemic treatments, percutaneous ablation, and stereotactic body radiation therapy (SBRT)
The study published by Vogl et al [11], showed better local control in patients with colorectal cancer lung metastases treated with microwave ablation (MWA) (88.3%) than in patients treated with
Patientswith with liver liver and and lung cancer cancan be be treated with a curative intention, and this context has become more frequent in recent years
Summary
ESMO guidelines [1] indicate that the selection of the best tools for the treatment of oligometastatic patients should be based on the following:. The size and localization of the metastases and access regarding selection of the best treatment method; The local control rates achieved (with greater local control for surgery than for the remaining options); The invasiveness of the technique; The non-tumor-related prognostic considerations and patient-relevant factors as well as patient preferences; The local expertise regarding the use of each ablative treatment method; Consideration of patient frailty and life expectancy [2]
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