Cancer that spreads beyond the wall of the colon often requires more complex treatment than localized CRC. Of the approximately 150,000 patients who are diagnosed with colorectal cancer every year, about 15% will learn that their cancer has spread to their liver when they are initially diagnosed. A further 35% will likely have their cancer spread to the liver during disease advancement or recurrence. Up to 60% of all people diagnosed with CRC will ultimately develop tumors in the liver.
The ‘gold standard’ for a cure is to surgically remove the tumors from the liver, a procedure called tumor resection; unfortunately, at the time of diagnosis only 15% to 20% of the patients who are diagnosed with liver metastases are candidates for surgical resection of their tumors.
For patients who have undergone potentially curative resection, disease recurrence is thought to arise from clinically occult micrometastases (tiny clusters of cancer cells) that are present at the time of surgery. The goal of postoperative (adjuvant) therapy is to eradicate these micrometastases, thereby increasing the cure rate. To treat suspected micrometastases in the remaining liver and prevent extrahepatic spread, a reasonable approach involves the use of a combination of regional therapy, such as hepatic artery infusion of chemotherapy, and systemic chemotherapy .
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