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Clin Colon Rectal Surg 2024; 37(04): 248-255
DOI: 10.1055/s-0043-1770719
Review Article

Stage IV Rectal Cancer and Timing of Surgical Approach

Roheena Z. Panni
1   Complex General Surgical Oncology, Hepatopancreatobiliary Surgery, Memorial Sloan Kettering Cancer Center, New York
,
Michael D'Angelica
2   Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, Cornell University, New York
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Abstract

Liver metastases are seen in at least 60% of patients with colorectal cancer at some point during the course of their disease. The management of both primary and liver disease is uniquely challenging in rectal cancer due to competing treatments and complex sequence of treatments depending on the clinical presentation of disease. Recently, several novel concepts are shaping new treatment paradigms, including changes in timing, sequence, and duration of therapies combined with potential deescalation of treatment components. Overall, the treatment of this clinical scenario mandates multidisciplinary evaluation and personalization of care; however, there is still considerable debate regarding the timing of liver metastasectomy in the context of the overall treatment plan. Herein, we will discuss the current literature on management of rectal cancer with synchronous liver metastasis, current treatment approaches with respect to chemotherapy, and role of hepatic artery infusion therapy.

Keywords

colorectal liver metastasis - metastatic rectal cancer - timing of surgery


Publication History

Article published online:
10 August 2023

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