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Prognosis and Management of Recurrent Metastatic Colorectal Cancer

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Colorectal Cancer Liver Metastases

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Abstract

Colorectal cancer is the second leading cause of cancer-related death in the Western world (Siegel et al. CA Cancer J Clin 68:7–30, 2018). One-half of patients with colorectal cancer will eventually develop metastatic disease. A subset of patients with disease localized to the liver are cured with surgical resection. Unfortunately, approximately 60% of patients will develop disease recurrence with nearly two-thirds having disease within the liver (Wei et al. Ann Surg Oncol 13:668–76, 2006; Wicherts et al. Ann Surg 248:994–1005, 2008; Choti et al. Ann Surg 235:759–66, 2002; Nanji et al. Ann Surg Oncol 20:295–304, 2013; House et al. J Am Coll Surgeons 210:744–52, 2010; Abdalla et al. Ann Surg 239:818–25, 2004). Techniques including nonanatomic parenchymal-sparing resections, success in induced hypertrophy of the remnant liver by portal vein embolization (PVE), and two-staged hepatectomy as well as associating liver partition and portal vein ligation (ALPPS) have enabled complete extirpation of colorectal liver metastasis (CRLM) at greater rates. Liver-directed therapy, including local and locoregional strategies, has allowed further treatment of liver lesions in distributions unfavorable for resection. Liver-directed therapy is often used in combination with resection with a goal to treat all visible tumors either by resection or tumor destruction with appropriate margins. Tumor recurrence after “curative” resection is a major problem. The majority of patients will die from recurrent disease, and liver metastases are the commonest cause of death for patients with colorectal cancer (House et al. J Am Coll Surgeons 210:744–52, 2010). Of patients who undergo liver resection, 50–75% will develop disease recurrence within 2 years after resection (Kun-Ming et al. World J Surg Oncol 12:155, 2014; Min-Su et al. Ann Surg Treat Res 87(1):14–21, 2014). Many recurrences are extra-hepatic; thus, adjuvant systemic treatment is standard of care after the management of CRLM.

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References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68:7–30.

    Article  PubMed  Google Scholar 

  2. Wei AC, Greig PD, Grant D, et al. Survival after hepatic resection for colorectal metastases: a 10-year experience. Ann Surg Oncol. 2006;13:668–76.

    Article  PubMed  Google Scholar 

  3. Wicherts DA, Miller R, de Haas RJ, et al. Long-term results of two stage hepatectomy for irresectable colorectal cancer liver metastases. Ann Surg. 2008;248:994–1005.

    Article  PubMed  Google Scholar 

  4. Choti MA, Sitzmann JV, Tiburi MF, et al. Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg. 2002;235:759–66.

    PubMed  PubMed Central  Google Scholar 

  5. Nanji S, Cleary S, Ryan P, et al. Up-front hepatic resection for metastatic colorectal cancer results in favorable long-term survival. Ann Surg Oncol. 2013;20:295–304.

    Article  PubMed  Google Scholar 

  6. House MG, Ito H, Gonen M, et al. Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. J Am Coll Surgeons. 2010;210:744–52. 752–745.

    Article  Google Scholar 

  7. Abdalla EK, Vauthey JN, Ellis LM, et al. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg. 2004;239:818–25.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Riihimaki M, Hemminki A, Sundquist J, et al. Patterns of metastasis in colon and rectal cancer. Sci Rep. 2016;6:29765.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  9. Kun-Ming C, Tsung-Han W, Chih-Hsien C, Wei-Chen L, Jy-Ming C, Jinn-Shiun C, Jeng-Yi W. Prognostic significance of the number of tumors and aggressive surgical approach in colorectal cancer hepatic metastasis. World J Surg Oncol. 2014;12:155.

    Article  Google Scholar 

  10. Min-Su P, Nam-Joon Y, Sang-Yong S, Tae Y, Suk-Won S, Young Rok C, Ki H, Geun H, Kyoung Bun L, et al. Histopathologic factors affecting tumor recurrence after hepatic resection in colorectal liver metastases. Ann Surg Treat Res. 2014;87(1):14–21.

    Article  Google Scholar 

  11. Tomlinson JS, Jarnagin WR, DeMatteo RP, et al. Actual 10-year survival after resection of colorectal liver metastases defines cure. J Clin Oncol. 2007;25:4575–80.

    Article  PubMed  Google Scholar 

  12. Hallet J, Sa Cunha A, Adams R, et al. Factors influencing recurrence following initial hepatectomy for colorectal liver metastases. BJS. 2016;103:1366–76.

    Article  CAS  Google Scholar 

  13. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Colon Cancer. Version 2.2018, March 14, 2018. Available at: https://www.nccn.org/professionals/physician_gls/pdf/colon.pdf.

  14. Hyder O, Dodson RM, Mayo SC, et al. Post-treatment surveillance of patients with colorectal cancer with surgically treated liver metastases. Surgery. 2013;154:256–65.

    Article  PubMed  Google Scholar 

  15. Lee DH, Lee JM, Hur BY, et al. Colorectal cancer liver metastases: diagnostic performance and prognostic value of PET/MR imaging. Radiology. 2016;280:782–92.

    Article  PubMed  Google Scholar 

  16. Steele S, Chang G, Hendren S, et al. Practice guideline for the surveillance of patients after curative treatment of colon and rectal cancer. Dis Colon Rectum. 2015;58:713–25.

    Article  PubMed  Google Scholar 

  17. Glynne-Jones R, Wyrwicz L, Tiret E, et al. Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28:iv22–40.

    Article  CAS  PubMed  Google Scholar 

  18. Van Cutsem E, Cervantes A, Nordlinger B, et al. Metastatic colorectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2014;25:ii1–9.

    Article  Google Scholar 

  19. Watanabe T, Muro K, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol. 2018;23:1–34.

    Article  PubMed  Google Scholar 

  20. Cancer Care Ontario: Colorectal Cancer Follow-up Care Pathway Map. Version 2018.03, March 14, 2018. Available at: https://www.cancercareontario.ca/sites/ccocancercare/files/assets/DPMColorectalFollowUp.pdf.

  21. Moulton CA, Gu CS, Law CH, et al. Effect of PET before liver resection on surgical management for colorectal adenocarcinoma metastases: a randomized clinical trial. JAMA. 2014;311:1863–9.

    Article  CAS  PubMed  Google Scholar 

  22. Fernandez FG, Drebin JA, Linehan DC, et al. Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose (FGG-PET). Ann Surg. 2004;240:438–47.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fernandez FG, Ritter J, Goodwin JW, Linehan DC, Hawkins WG, Strasberg SM. Effect of steatohepatitis associated with irinotecan or oxaliplatin pretreatment on resectability of hepatic colorectal metastases. J Am Coll Surg. 2005;200:845–53.

    Article  PubMed  Google Scholar 

  24. Vauthey JN, Pawlik TM, Ribero D, et al. Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol. 2006;24:2065–72.

    Article  CAS  PubMed  Google Scholar 

  25. Zorzi D, Laurent A, Pawlik TM, Lauwers GY, Vauthey JN, Abdalla EK. Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases. Br J Surg. 2007;94:274–86.

    Article  CAS  PubMed  Google Scholar 

  26. Morris-Stiff G, Tan YM, Vauthey JN. Hepatic complications following preoperative chemotherapy with oxaliplatin or irinotecan for hepatic colorectal metastases. Eur J Surg Oncol. 2008;34:609–14.

    Article  CAS  PubMed  Google Scholar 

  27. De Jong MC, Pulitano C, Ribero D, et al. Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients. Ann Surg. 2009;250:440–8.

    PubMed  Google Scholar 

  28. Butte JM, Gonen M, Allen PJ, et al. Recurrence after partial hepatectomy for metastatic colorectal cancer: the potentially curative role of salvage re-resection. Ann Surg Oncol. 2015;22:2761–71.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Dupre A, Lefranc A, Buc E, et al. Use of bioresorbable membranes to reduce abdominal and perihepatic adhesions in 2-stage hepatectomy of liver metastases form colorectal cancer: results of a prospective, randomized controlled phase II trial. Ann Surg. 2013;258:30–6.

    Article  PubMed  Google Scholar 

  30. Lange JF, Leese T, Casting D, Bismuth H. Repeat hepatectomy for recurrent malignant tumors of the liver. Surg Gynecol Obstet. 1989;169:119–26.

    CAS  PubMed  Google Scholar 

  31. Adair RA, Young AL, Cockbain AJ, et al. Repeat hepatic resection for colorectal liver metastases. Br J Surg. 2012;99:1278–83.

    Article  CAS  PubMed  Google Scholar 

  32. Pinson CW, Wright JK, Chapman WC, et al. Repeat hepatic surgery for colorectal cancer metastasis to the liver. Ann Surg. 1996;223:765–73. discussion 773–6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Lee H, Choi SH, Cho YB, et al. Repeat hepatic resection in patients with colorectal liver metastases. World J Gastroenterol. 2015;21:2124–30.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Saiura A, Yamamoto J, Koga R, et al. Favorable outcome after repeat resection for colorectal liver metastases. Ann Surg Oncol. 2014;21:4293–9.

    Article  PubMed  Google Scholar 

  35. Petrowsky H, Gonen M, Jarnagin W, et al. Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis. Ann Surg. 2002;235:863–71.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Nanji S, Tsang ME, Wei X, et al. Outcomes after repeat hepatic resection for recurrent metastatic colorectal cancer: a population-based study. Am J Surg. 2017;213:1053–9.

    Article  PubMed  Google Scholar 

  37. Lam VWT, Pang T, Laurence JM, et al. A systematic review of repeat hepatectomy for recurrent colorectal liver metastases. J Gastrointest Surg. 2013;17:1312–21.

    Article  PubMed  Google Scholar 

  38. Leung U, Gonen M, Allen P, et al. Colorectal cancer liver metastases and concurrent extrahepatic disease treated with resection. Ann Surg. 2017;265:158–65.

    Article  PubMed  Google Scholar 

  39. Bellier J, De Wolf J, Hebbar M, et al. Repeated resections of hepatic and pulmonary metastasis from colorectal cancer provide long-term survival. World J Surg. 2018;42(4):1171–9.

    Article  PubMed  Google Scholar 

  40. Passot G, Denbo JW, Yamashita S, et al. Is hepatectomy justified for patients with RAS mutant colorectal liver metastases? An analysis of 524 patients undergoing curative liver resection. Surgery. 2017;161:332–40.

    Article  PubMed  Google Scholar 

  41. Kemeny N, Chou J, Capanu M, et al. KRAS mutation influences recurrence patterns in patients undergoing hepatic resection of colorectal metastases. Cancer. 2014;120:3965–71.

    Article  CAS  PubMed  Google Scholar 

  42. Schirripa M, Bergamo F, Cremolini C, et al. BRAF and RAS mutations as prognostic factors in metastatic colorectal cancer patients undergoing liver resection. Br J Cancer. 2015;9:1921–8.

    Article  CAS  Google Scholar 

  43. Teng HW, Huang YC, Lin JK, et al. BRAF mutation is a prognostic biomarker for colorectal liver metastectomy. J Surg Oncol. 2012;106:123–9.

    Article  CAS  PubMed  Google Scholar 

  44. Yaeger R, Cereck A, Chou JF, et al. BRAF mutation predicts for poor outcomes after metastectomy in patients with metastatic colorectal cancer. Cancer. 2014;120:2316–24.

    Article  CAS  PubMed  Google Scholar 

  45. Heinemann V, von Weikersthal LF, Decker T, et al. FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab as first-line treatment for patients with metastatic colorectal cancer (FIRE-3): a randomised, open-label, phase 3 trial. Lancet Oncol. 2014;15:1065–75.

    Article  CAS  PubMed  Google Scholar 

  46. Cremolini C, Loupakis F, Antoniotti C, et al. FOLFOXIRI plus bevacizumab versus FOLFIRI plus bevacizumab as first-line treatment of patients with metastatic colorectal cancer: updated overall survival and molecular subgroup analysis of the open-label, phase 3 TRIBE study. Lancet Oncol. 2015;16:1306–15.

    Article  CAS  PubMed  Google Scholar 

  47. Simkens LH, van Tinteren H, ten Tije AJ, et al. Maintenance treatment with capecitabine and bevacizumab in metastatic colorectal cancer (CAIRO3): a phase 3 randomised controlled trial of the Dutch colorectal cancer group. Lancet. 2015;9:1843–52.

    Article  CAS  Google Scholar 

  48. Le CT, Uram JN, Wang H, et al. PD-1 blockade in tumors with mismatch-repair deficiency. N Engl J Med. 2015;372:2509–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Grothey A, Van Cutsem E, Sobrero A, et al. Regorafenib monotherapy for previously treated metastatic colorectal cancer (CORRECT): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet. 2013;381:303–12.

    Article  CAS  PubMed  Google Scholar 

  50. Karapetis CS, Khambata-Ford S, Jonker DJ, et al. K-ras mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med. 2008;359:1757–65.

    Article  CAS  PubMed  Google Scholar 

  51. Jonker DJ, O’Callaghan CJ, Karapetis CS, et al. Cetuximab for the treatment of colorectal cancer. N Engl J Med. 2007;357:2040–8.

    Article  CAS  PubMed  Google Scholar 

  52. Gervais DA, Goldberg SN, Brown DB, et al. Society of interventional radiology position statement on percutaneous radiofrequency ablation for the treatment of liver tumors. J Vasc Interv Radiol. 2009;20:S42–7.

    Article  Google Scholar 

  53. Weng M, Zhang Y, Zhou D, et al. Radiofrequency ablation versus resection for colorectal liver metastases: a meta-analysis. PLoS One. 2012;7:e45493.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Otto G, Duber C, Hoppe-Lotichius M, et al. Radiofrequency ablation as first-line treatment in patients with early colorectal liver metastases amenable to surgery. Ann Surg. 2010;251:796–803.

    Article  PubMed  Google Scholar 

  55. Dupre A, Jones RP, Diaz-Nieto R, et al. Curative-intent treatment of recurrent colorectal liver metastases: a comparison between ablation and resection. Eur J Surg Oncol. 2017;43:1901–7.

    Article  PubMed  Google Scholar 

  56. Van Amerongen MJ, van der Stok EP, Futterer JJ, et al. Short term and long term results of patients with colorectal liver metastases undergoing surgery with or without radiofrequency ablation. Eur J Surg Oncol. 2016;42:523–30.

    Article  PubMed  Google Scholar 

  57. Ruers T, Van Coevorden F, Punt CJ, et al. Local treatment of unresectable colorectal liver metastases: results of a randomized phase II trial. J Natl Cancer Inst. 2017;109:djx015.

    PubMed Central  Google Scholar 

  58. Ensminger WD, Gyves JW. Clinical pharmacology of hepatic arterial chemotherapy. Semin Oncol. 1983;10:176–82.

    CAS  PubMed  Google Scholar 

  59. Kemeny N, Conti JA, Cohen A, et al. Phase II study of hepatic arterial floxuridine, leucovorin, and dexamethasone for unresectable liver metastases from colorectal carcinoma. J Clin Oncol. 1994;12:2288–95.

    Article  CAS  PubMed  Google Scholar 

  60. Allen PJ, Nissan A, Picon AI, et al. Technical complications oand durability of hepatic artery infusion pumps for unresectable colorectal liver metastases: an institutional experience of 544 consecutive cases. J Am Coll Surg. 2005;201:57–65.

    Article  PubMed  Google Scholar 

  61. Ammori JB, Kemeny NE, Fong Y, et al. Conversion to complete resection and/or ablation using hepatic artery infusional chemotherapy in patients with unresectable liver metastases from colorectal cancer: a decade of experience at a single institution. Ann Surg Oncol. 2013;20:2901–7.

    Article  PubMed  Google Scholar 

  62. D’Angelica MI, Correa-Gallego C, Paty PB, et al. Phase II trial of hepatic artery infusional and systemic chemotherapy for patients with unresectable hepatic metastases from colorectal cancer: conversion to resection and long-term outcomes. Ann Surg. 2015;261:353–60.

    Article  PubMed  Google Scholar 

  63. Ariel IM. Treatment of inoperable primary pancreatic and liver cancer by the intra-arterial administration of radioactive isotopes (y90 radiating microspheres). Ann Surg. 1965;162:267–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Hickey R, Lewandowski RJ, Prudhomme T, et al. 90Y radioembolization of colorectal hepatic metastases using glass microspheres: safety and survival outcomes from a 531-patient multicenter study. J Nucl Med. 2016;57:665–71.

    Article  CAS  PubMed  Google Scholar 

  65. Saxena A, Meteling B, Kapoor J, Golani S, Morris DL, Bester L. Is yttrium-90 radioembolization a viable treatment option for unresectable, chemorefractory colorectal cancer liver metastases? A large single-center experience of 302 patients. Ann Surg Oncol. 2015;22:794–802.

    Article  PubMed  Google Scholar 

  66. Lewandowski RJ, Memon K, Mulcahy MF, et al. Twelve-year experience of radioembolization for colorectal hepatic metastases in 214 patients: survival by era and chemotherapy. Eur J Nucl Med Mol Imaging. 2014;41:1861–9.

    Article  CAS  PubMed  Google Scholar 

  67. Kennedy AS, Coldwell D, Nutting C, et al. Resin 90Y-microsphere brachytherapy for unresectable colorectal liver metastases: modern USA experience. Int J Radiat Oncol Biol Phys. 2006;65:412–25.

    Article  CAS  PubMed  Google Scholar 

  68. Riaz A, Awais R, Salem R. Side effects of yttrium-90 radioembolization. Front Oncol. 2014;4:198.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Kennedy AS, Ball D, Cohen SJ, et al. Multicenter evaluation of the safety and efficacy of radioembolization in patients with unresectable colorectal liver metastases selected as candidates for (90)Y resin microspheres. J Gastrointest Oncol. 2015;6:134–42.

    PubMed  PubMed Central  Google Scholar 

  70. Wasan HS, Gibbs P, Sharma NK, et al. First-line selective internal radiotherapy plus chemotherapy versus chemotherapy alone in patients with liver metastases from colorectal cancer (FOLFIRE, SIRFLOX, and FOXFIRE-Global): a combined analysis of three multicentre, randomised, phase 3 trials. Lancet Oncol. 2017;18:1159–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Braat MNGJA, Samim M, van den Bosch MAAJ, et al. The role of 90Y-radioembolization in downstaging primary and secondary hepatic malignancies: a systematic review. Clin Transl Imaging. 2016;4:283–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Justinger C, Kouladouros K, Gartner D, et al. Liver resection after selective internal radiotherapy (SIRT): proof of concept, intial survival, and safety. J Surg Oncol. 2015;112:436–42.

    Article  PubMed  Google Scholar 

  73. Whitney R, Tatum C, Hahl M, et al. Safety of hepatic resection in metastatic disease to the liver after yttrium-90 therapy. J Surg Res. 2011;166:236–40.

    Article  PubMed  Google Scholar 

  74. Moir JA, Burns J, Barnes J, et al. Selective internal radiation therapy for liver malignancies. Br J Surg. 2015;102:1533–40.

    Article  CAS  PubMed  Google Scholar 

  75. Martin RC 2nd, Scoggins CR, Schreeder M, et al. Randomized controlled trial of irinotecan drug-eluting beads with simultaneous FOLFOX and bevacizumab for patients with unresectable colorectal liver-limited metastases. Cancer. 2015;121:3649–58.

    Article  CAS  PubMed  Google Scholar 

  76. Richardson AJ, Laurence JM, Lam VW. Transarterial chemoembolization with irinotecan beads in the treatment of colorectal liver metastases: as ystematic revie. J Vasc Interv Radiol. 2013;24:1209–17.

    Article  PubMed  Google Scholar 

  77. McPartlin A, Swaminath A, Wang R, et al. Long-term outcomes of phase 1 and 2 studies of SPBRT for hepatic colorectal metastases. Int J Radiat Oncol Biol Phys. 2017;99:388–95.

    Article  PubMed  Google Scholar 

  78. Mahadevan A, Blanck O, Lanciano R, et al. Stereotactic body radiotherapy (SBRT) for liver metastasis – clinical outcomes from the international multi-institutional RSSearch® patient registry. Radiat Oncol. 2018;13:26.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Rule W, Timmerman R, Tong L, et al. Phase I dose-escalation study of stereotactic body radiotherapy in patients with hepatic metastases. Ann Surg Oncol. 2011;18:1081–7.

    Article  PubMed  Google Scholar 

  80. Colbert LE, Cloyd JM, Koay EJ, et al. Proton beam radiation as salvage therapy for bilateral colorectal liver metastases not amenable to second-stage hepatectomy. Surgery. 2017;161:1543–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Transplantation Surgery, Department of Surgery at University of Nebraska Medical Center, Omaha, NE, USA

    Blaire Anderson

  2. Department of Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St. Louis, MO, USA

    Ryan C. Fields

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  1. Blaire Anderson
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  1. National Cancer Institute, Rio de Janeiro, Brazil

    Mauro Monteiro Correia

  2. Banner MD Anderson Cancer Center, Phoenix, AZ, USA

    Michael A. Choti

  3. Virginia Mason Medical Center, Seattle, WA, USA

    Flavio G. Rocha

  4. Center for Advanced Treatment of HBP Diseases, Ageo Central General Hospital, Ageo Shi, Saitama, Japan

    Go Wakabayashi

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Anderson, B., Fields, R.C. (2020). Prognosis and Management of Recurrent Metastatic Colorectal Cancer. In: Correia, M., Choti, M., Rocha, F., Wakabayashi, G. (eds) Colorectal Cancer Liver Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-25486-5_42

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