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World J Gastroenterol. Apr 21, 2016; 22(15): 3937-3944
Published online Apr 21, 2016. doi: 10.3748/wjg.v22.i15.3937
Missing metastases as a model to challenge current therapeutic algorithms in colorectal liver metastases
Valerio Lucidi, Alain Hendlisz, Jean-Luc Van Laethem, Vincent Donckier
Valerio Lucidi, Department of Abdominal Surgery, Hôpital Erasme, Centre de Chirurgie Hépato-Biliaire de l’ULB, Université Libre de Bruxelles, 1070 Brussels, Belgium
Alain Hendlisz, Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, 1000 Brussels, Belgium
Jean-Luc Van Laethem, Department of Gastroenterology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium
Vincent Donckier, Department of Surgery, Institut Jules Bordet, Department of Abdominal Surgery, Hôpital Erasme, Centre de Chirurgie Hépato-Biliaire de l’ULB, Université Libre de Bruxelles, 1000 Brussels, Belgium
Author contributions: Lucidi V, Hendlisz A, Van Laethem JL and Donckier V wrote the paper.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
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: Vincent Donckier, MD, PhD, Professor of Surgery, Institut Jules Bordet, Department of Abdominal Surgery, Hôpital Erasme, Centre de Chirurgie Hépato-Biliaire de l’ULB, Université Libre de Bruxelles, Rue Héger-Bordet, 1, 1000 Brussels, Belgium. vincent.donckier@erasme.ulb.ac.be
Telephone: +32-2-5413158 Fax: +32-2-5413141
Received: December 29, 2015
Peer-review started: December 30, 2015
First decision: January 28, 2016
Revised: February 15, 2016
Accepted: March 18, 2016
Article in press: March 18, 2016
Published online: April 21, 2016
Processing time: 96 Days and 18.5 Hours
Core Tip

Core tip: Surgery is considered as the only potentially curative option for patients with colorectal liver metastases, while chemotherapy alone is considered as a palliative treatment. Recent data shown that colorectal liver metastases disappearing after chemotherapy, so-called missing metastases, could not reappear on the long-term, suggesting that systemic treatments might be curative in selected cases. Accordingly, we propose that classical recommendation to limit surgery only when all initial tumor sites could be resected might have become partially obsolete. Furthermore, when missing liver metastases have been induced, adjuvant surgery targeting the resistant part of the disease could represent a new strategy.