Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2016; 22(21): 4963-4965
Published online Jun 7, 2016. doi: 10.3748/wjg.v22.i21.4963
Surgical dilemmas in the management of colorectal liver metastases: The role of timing
Dimitrios Dimitroulis, Gregory Kouraklis
Dimitrios Dimitroulis, Gregory Kouraklis, Second Department of Surgery, University of Athens Medical School, Athens Greece, Laiko Hospital, 11527 Athens, Greece
Author contributions: Dimitroulis D and Kouraklis G wrote the manuscript; Kouraklis G edited the manuscript.
Conflict-of-interest statement: The authors have no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dimitrios Dimitroulis, MD, PhD, Associate Professor, Second Department of Surgery, University of Athens Medical School, Athens Greece, Laiko Hospital, M. Asias str 75, 11527 Athens, Greece. dimitroulisdimitrios@yahoo.com
Telephone: +30-6972-420547 Fax: +30-210-7456972
Received: February 23, 2016
Peer-review started: February 24, 2016
First decision: March 31, 2016
Revised: April 19, 2016
Accepted: May 4, 2016
Article in press: May 4, 2016
Published online: June 7, 2016
Processing time: 97 Days and 3.6 Hours
Abstract

Colorectal cancer (CRC) is an emerging health problem in the Western World both for its raising tendency as well as for its metastatic potential. Almost half of the patients with CRC will develop liver metastases during the course of their disease. The liver surgeon dealing with colorectal liver metastases faces several surgical dilemmas especially in the setting of the timing of operation. Synchronous resectable metastases should be treated prior or after induction chemotherapy? Furthermore in the case of synchronous colorectal liver metastases which organ should we first deal with, the liver or the colon? All these questions are set in the editorial and impulse for further investigation is put focusing on multidisciplinary approach and individualization of treatment modalities.

Keywords: Colorectal cancer; Chemotherapy; Timing of surgery; Colorectal liver metastases; Liver first procedure; Multidisciplinary approach; Individualized treatment strategies

Core tip: The treatment of colorectal cancer with colorectal liver metastases is a challenge for the multidisciplinary medical team dealing with this problem. The timing of surgery both for synchronous as well as for metachronous metastases is always a matter of debate. Multidisciplinary approach and individualization of treatment strategies is suggested.