Interventional radiology in management of colorectal carcinoma metastasis
Colon Polyps and Colorectal Cancer: Second Edition, Springer International Publishing Ag, ss.629-662, 2020
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2020
- Doi Numarası: 10.1007/978-3-030-57273-0_31
- Yayınevi: Springer International Publishing Ag
- Sayfa Sayıları: ss.629-662
- Anahtar Kelimeler: Ablation, Chemoembolization, Colorectal cancer, Embolization, Interventional radiology, Metastasis, Portal vein, Treatment
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Colorectal cancer is one of the most common causes of death globally. The rate of metastases at the time of diagnosis is reported to be 20-25% in colorectal cancer. Additionally, it is reported that 50-60% of remaining population will have metastatic disease in due course. Although surgery is the first-line management of colorectal liver metastases, only 10-25% are eligible for surgical excision. In inoperable colorectal metastatic disease, National Comprehensive Cancer Network guidelines suggest systemic chemotherapy. Over the past several decades, interventional radiological treatments have evolved and started to play an important role in the management of patients refractory to systemic chemotherapy. The locoregional treatments used in colorectal metastases consist of percutaneous ablations (radiofrequency, microwave, laser, cryoablation) and intra-arterial therapies (hepatic arterial infusion, conventional transarterial chemoembolization, transarterial chemoembolization with drug-eluting beads, and transarterial radioembolization). Portal vein embolization causes induction of selective hypertrophy of the non-diseased portion of the liver; thus increase in future liver remnant provides fewer complications and shorter hospital stays following resection. In this chapter, locoregional therapies including ablative and intra-arterial treatments for liver and lung metastases and portal vein embolization to induce hypertrophy prior to surgery are reviewed.