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What is your approach to systemic therapy in newly diagnosed colon cancer with synchronous solitary liver metastases?

Do you offer chemotherapy upfront in all patients or only if borderline resectable/unresectable? If you treat, what regimen do you use and how long before proceeding to surgery, given associations of steatosis with 5-FU/irinotecan and sinusoidal obstruction syndrome with oxaliplatin?
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How do you treat newly diagnosed colon cancer with a solitary liver met?

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1 Answer
Mednet Member
Mednet MemberInvited Expert
Medical Oncology · Jefferson Kimmel Cancer Center
Answered on

This is an important and challenging clinical question. In general, I favor a neoadjuvant chemotherapy treatment approach for a variety of reasons. For one, the EORTC trial provides us with supportive data that perioperative FOLFOX is associated with a modest improvement in outcome compared to surge...

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