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Surgery First May Offer Better Survival for Colorectal Cancer With Liver Spread

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Surgery First May Offer Better Survival for Colorectal Cancer With Liver Spread

When colorectal cancer spreads to the liver, doctors often debate whether patients should have chemotherapy first or go straight to surgery if the liver tumors can be removed. A new study looked at more than 300 patients to see which strategy leads to better outcomes.

The patients were divided into two groups:
– Operation-first: surgery to remove the cancer followed by chemotherapy.
– Chemotherapy-first: chemotherapy before surgery.

The results showed that patients who had surgery first lived longer and had fewer recurrences compared to those who started with chemotherapy. This suggests that removing the cancer as soon as possible may be the best choice when surgery is possible.

The study also found that adding targeted therapies around the time of surgery did not improve survival and was actually linked with worse outcomes. For patients whose cancer came back, those with limited recurrence (oligorecurrence) did better if they had another local treatment, such as surgery or ablation, instead of chemotherapy alone.

These findings suggest that for patients with colorectal cancer and resectable liver metastases, an operation-first approach may provide the best chance for long-term survival. Still, more research is needed before this becomes a standard recommendation.

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Dr Harsh Shah - GI & HPB Oncosurgeon in Ahmeadbad
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