Waisberg J, Ivankovics IG. Liver-first approach of colorectal cancer with synchronous hepatic metastases: A reverse strategy. World J Hepatol 2015; 7(11): 1444-1449 [PMID: 26085905 DOI: 10.4254/wjh.v7.i11.1444]
Corresponding Author of This Article
Jaques Waisberg, MD, PhD, FACS, Professor, Head of the ABC Medical School, Department of Surgery, ABC Medical School, Avenida Príncipe de Gales 821, Santo André, São Paulo 09060-650, Brazil. jaqueswaisberg@uol.com.br
Research Domain of This Article
Surgery
Article-Type of This Article
Editorial
Open-Access Policy of This Article
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/
World J Hepatol. Jun 18, 2015; 7(11): 1444-1449 Published online Jun 18, 2015. doi: 10.4254/wjh.v7.i11.1444
Liver-first approach of colorectal cancer with synchronous hepatic metastases: A reverse strategy
Jaques Waisberg, Ivan Gregório Ivankovics
Jaques Waisberg, Department of Surgery, ABC Medical School, Santo André, São Paulo 09060-650, Brazil
Ivan Gregório Ivankovics, Department of Medicine, Rondônia Federal University, Porto Velho 78900-500, Rondônia, Brazil
Author contributions: Waisberg J and Ivankovics IG equally contributed to this paper.
Conflict-of-interest: I declare that I have no conflict of interest in the manuscript entitled: Liver-first approach of colorectal cancer hepatic metastases with synchronous: A reverse strategy.
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: Jaques Waisberg, MD, PhD, FACS, Professor, Head of the ABC Medical School, Department of Surgery, ABC Medical School, Avenida Príncipe de Gales 821, Santo André, São Paulo 09060-650, Brazil. jaqueswaisberg@uol.com.br
Telephone: +55-11-982560018 Fax: +55-11-44367839
Received: January 21, 2015 Peer-review started: January 25, 2015 First decision: February 7, 2015 Revised: March 20, 2015 Accepted: April 10, 2015 Article in press: April 14, 2015 Published online: June 18, 2015 Processing time: 146 Days and 11.5 Hours
Core Tip
Core tip: The liver-first approach or reverse strategy is a downstaging regimen, and it consists of systemic chemotherapy, chemoradiotherapy and/or biological agents, followed by resection of colorectal hepatic metastases prior to removal the primary colorectal tumor. It is a promising strategy in patients with synchronous colorectal liver metastases. The rationale behind this liver-first strategy is initially control of synchronous hepatic metastases of colorectal carcinoma, which can optimize the opportunity of a potentially curative liver resection and longstanding survival. The liver-first strategy can be applied for patients with early stage colorectal carcinoma and synchronous hepatic metastases. Extensive or locally advanced rectal carcinoma with limited or advanced synchronous hepatic metastases and asymptomatic colonic carcinoma with extensive synchronous hepatic metastases may be submitted to the liver-first strategy.
