Strategy and tactics of treatment in patients with metastatic colorectal cancer

Abstract

Colorectal cancer is one of the most frequently detected malignancies worldwide. Incidence and mortality rates continue to grow steadily that is due, on the one hand, to the late disease diagnostics, and on the other hand – to the high distant metastases rate. More than a half of all metastatic colorectal cancer patients reveal distant liver metastases. The isolated liver lesions can be the only systemic disease manifestation when early cytoreduction allows the achievement of a significant increase in life expectancy, and in some cases – the complete recovery of such patients. However, so far there was no uniform treatment strategy of patients with colorectal cancer with liver metastases due to the heterogeneity of patients and the difficulties of selecting the treatment volume. The world’s leading experts have made an attempt to identify a number of prognostic factors for the selection of patients who have been considered suitable for an intensive treatment due to their metastatic disease. It is generally recognized that the conduction of combined treatment in these patients significantly improves survival but the choice of specific treatment and the timing of its application is still a subject of debates among experts. The authors present their own data concerning the methods and the results of metastatic colorectal cancer patients’ treatment.