Clinical Trials Study
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World J Hepatol. Jul 27, 2014; 6(7): 513-519
Published online Jul 27, 2014. doi: 10.4254/wjh.v6.i7.513
Patients with multiple synchronous colonic cancer hepatic metastases benefit from enrolment in a “liver first” approach protocol
Dimitrios Kardassis, Achilleas Ntinas, Dimosthenis Miliaras, Alexandros Kofokotsios, Konstantinos Papazisis, Dionisios Vrochides
Dimitrios Kardassis, Achilleas Ntinas, Dionisios Vrochides, Centre for Hepato-Pancreato-Biliary Surgery, “Euromedica Geniki Kliniki” General Hospital, 54645 Thessaloniki, Greece
Dimosthenis Miliaras, Department of Pathology, “Euromedica Geniki Kliniki” General Hospital, 54645 Thessaloniki, Greece
Alexandros Kofokotsios, Department of Interventional Gastroenterology, “Euromedica Geniki Kliniki” General Hospital, 54645 Thessaloniki, Greece
Konstantinos Papazisis, Department of Medical Oncology, “Euromedica Geniki Kliniki” General Hospital, 54645 Thessaloniki, Greece
Author contributions: Kardassis D, Ntinas A and Vrochides D conceived and designed the study, performed surgical procedures, analysed and interpreted the data, and wrote the manuscript; Kofokotsios A, Papazisis K and Miliaras D provided multi-disciplinary treatment of the enlisted patients based on their respective specialties and were also involved in editing the manuscript; all authors approved the manuscript.
Correspondence to: Dimitrios Kardassis, MD, Centre for Hepato-Pancreato-Biliary Surgery, “Euromedica Geniki Kliniki” General Hospital, R.: 701, 11 Maria Callas Street, 54645 Thessaloniki, Greece. dimitrios.kardassis@gmx.net
Telephone: +30-231-0895469 Fax: +30-23-10895196
Received: November 4, 2013
Revised: May 15, 2014
Accepted: May 28, 2014
Published online: July 27, 2014
Core Tip

Core tip: Complete tumour burden resection remains the only possible curative therapy for liver-limited colon cancer metastatic disease. However, there are different approaches regarding treatment of the primary tumour and its hepatic metastases, if the latter are synchronous and unresectable with one surgical procedure. For this subgroup of patients, a “liver first” approach protocol is introduced in order to assess standardised treatment as well as to prevent overtreatment in cases of undetected extra-hepatic metastatic dissemination or disease progression.