Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2015; 21(22): 7014-7021
Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.7014
Treatment strategies for colorectal carcinoma with synchronous liver metastases: Which way to go?
Peter Ihnát, Petr Vávra, Pavel Zonča
Peter Ihnát, Petr Vávra, Pavel Zonča, Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Ostrava 70300, Czech Republic
Peter Ihnát, Petr Vávra, Pavel Zonča, Department of Surgery, University Hospital Ostrava, Ostrava 70852, Czech Republic
Author contributions: Ihnát P and Zonča P performed the literature search; Ihnát P and Vávra P wrote the paper; Zonča P revised the paper.
Conflict-of-interest: All authors declare that they have no personal, political or financial conflicts of interest.
Data sharing: No additional data are available.
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: Peter Ihnát, MD, PhD, MBA, Department of Surgical Studies, Faculty of Medicine, University of Ostrava, Syllabova 19, Ostrava 70300, Czech Republic. peterihnat@yahoo.com
Telephone: + 42-597-375701 Fax: + 42-597-375054
Received: December 28, 2014
Peer-review started: December 29, 2014
First decision: January 22, 2015
Revised: February 6, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: June 14, 2015
Processing time: 172 Days and 0.7 Hours
Core Tip

Core tip: There are four treatment strategies available for synchronous liver metastases of colorectal carcinoma (CLM): (1) primary first approach comprises resection of the primary colorectal tumor followed by chemotherapy and liver resection; (2) simultaneous resection of liver and colorectal primary tumor; (3) liver-first (or chemotherapy-first) approach comprises preoperative chemotherapy, liver resection, adjuvant chemotherapy, and resection of the primary colorectal tumor (best for asymptomatic primary tumors and initially unresectable or marginally resectable CLM); and (4) up-front hepatectomy (or “true” liver-first approach) includes liver resection followed by adjuvant chemotherapy and colorectal resection (for asymptomatic primary tumors and initially resectable CLM).