Liver MRI in patients scheduled for local therapy of colorectal liver metastases
Mené sur 298 patients présentant des métastases hépatiques ayant pour origine un cancer colorectal (durée médiane de suivi : 21 mois ; 59 % d'hommes), cet essai international (Belgique, Italie, Norvège, Pays-Bas) évalue l'intérêt, dans le cadre d'un traitement localisé et du point de vue de la modification du plan de traitement, de l'ajout d'une IRM hépatique avec rehaussement de contraste à une tomographie numérique
Liver resection with perioperative chemotherapy is the most effective treatment for colorectal liver metastases. Surgical techniques for the treatment of colorectal liver metastases have expanded rapidly over the past decade. First, there has been the possibility to shift from the classic two-staged approach, whereby the colorectal cancer is resected first and synchronous colorectal liver metastases are resected during the second stage, to the simultaneous resection of both the colorectal cancer and synchronous colorectal liver metastases. Second, there has been increased use of local therapies and adoption of new techniques such as liver partition and portal vein ligation for staged hepatectomy, enhanced ultrasound-guided one-stage hepatectomy in case of bilobar colorectal liver metastases, and liver transplantation. All these improvements in the surgical field have allowed treating physicians to further expand the pool of patients who can be considered candidates for surgical treatment of colorectal liver metastases, with a net survival benefit.