Abstract
About 70% of patients with metastatic colorectal carcinoma (mCRC) have liver metastases. Hepatic failure accounts for most mCRC-related deaths. Therefore, controlling liver metastases may improve outcomes. A data overview of liver-directed treatment using yttrium-90 selective internal radiation therapy (SIRT) is provided as part of a multimodality treatment. SIRT in mCRC is discussed, and the prognostic factors for patient selection are defined. Pooled analyses of three recent trials incorporating SIRT plus chemotherapy revealed subsets of patients with mCRC who might benefit from SIRT. A multidisciplinary treatment for most mCRC patients is proposed to achieve long-term survival in this cohort of patients.
Highlights
Colorectal cancer (CRC) is the third-most common cancer diagnosis and the secondleading cause of cancer-related mortality in the United States [1]
Considering the goal of the study was to assess the impact of liver-directed therapy on the overall survival (OS) in metastatic colorectal cancer (mCRC), it is important to highlight some of the features of the combined analysis
There was no significant difference between the two groups in terms of the number of events, as demonstrated by the pooled hazard ratio (HR) of 1.04 (95% confidence interval (CI) 0.90–1.19; p = 0.609)
Summary
Colorectal cancer (CRC) is the third-most common cancer diagnosis and the secondleading cause of cancer-related mortality in the United States [1]. 145,600 cases each year, with a mortality rate of about 51,020 deaths per year [2]. The prognosis for metastatic colorectal cancer (mCRC) is dismal, with a 5-year survival rate of 11% [3]. Liver failure is the most common cause of death among patients with mCRC and accounts for about two-thirds of mCRC-related mortality [5]. This is partly due to metastatic tumor burden in the liver that replaces normal liver parenchyma, leading to a functional compromise with subsequent metabolic dysfunction.
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