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Conversion and Neoadjuvant Therapies

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Extreme Hepatic Surgery and Other Strategies

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Abstract

Widespread data from the literature show that surgery is the only hope of prolonged survival for patients with colorectal liver metastases (CLMs). Surgical technical advances, optimal systemic chemotherapy management, and increased awareness among all healthcare professionals of the benefits of screening, are responsible for the continuous growth in the number of patients eligible for curative surgery of CLMs. Many patients who were historically not candidates for this type of surgery and were treated with palliative methods now participate in multimodal treatment protocols that combine modern chemotherapy schemas and complex liver surgery.

Today, liver surgeons have to be aware of hepatotoxic effects of systemic chemotherapy agents on the non-tumoral liver parenchyma because such hepatotoxicity heralds an increased postoperative morbidity and mortality risk in patients with CLMs.

This chapter will discuss the current data on the role of systemic chemotherapy in a multidisciplinary approach in the treatment of CLMs, and it will focus on the neoadjuvant and conversion chemotherapy and its implications in surgical management.

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Authors and Affiliations

  1. Department of Surgery, Sanatorio San Lucas, San Isidro, Buenos Aires, Argentina

    Jorge Pablo Grondona

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  1. Jorge Pablo Grondona
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Editors and Affiliations

  1. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Eduardo de Santibañes

  2. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Victoria Ardiles

  3. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Fernando A. Alvarez

  4. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Virginia Cano Busnelli

  5. General Surgery Department HPB and Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Martin de Santibañes

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Grondona, J.P. (2017). Conversion and Neoadjuvant Therapies. In: de Santibañes, E., Ardiles, V., Alvarez, F., Busnelli, V., de Santibañes, M. (eds) Extreme Hepatic Surgery and Other Strategies. Springer, Cham. https://doi.org/10.1007/978-3-319-13896-1_6

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