Effectiveness of Positron Emission Tomography for Predicting Chemotherapy Response in Colorectal Cancer Liver Metastases by Glazer, Evan

“…For example, a few years ago an extrahepatic metastasis effectively eliminated surgical resection, but a combination of chemotherapeutic options and surgical techniques has expanded the indications for resection and increased the population of patients who may benefit.1,2 Neoadjuvant chemotherapy has increased the resectability rate by 11% to 37%.1 Unfortunately, greater than 80% of patients undergoing hepatic resection will have recurrences, mostly within the first 2 years.2 Nonetheless, the only hope for cure is resection, and prior surgical dogma based on the number of lesions, size of the tumor-free resection margin, and presence of resectable extrahepatic disease must be questioned.3- 5 The current standard approach to surgical planning is contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) for specific tumor characteristics or contraindications to CT.6 Several series showed that focal extrahepatic disease, an isolated pulmonary lesion, can be safely resected, with 5-year survival rates of 29% to 58%.7,8 In 1 series,7 17 of 30 patients required 3 or more resections. …”
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