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Resumen
La resección hepática es el tratamiento de elección de los pacientes con metástasis hepáticas de origen colorrectal. Actualmente se alcanzan índices de supervivencia del 25-40% a los 5 años. A pesar de que se ha demostrado la importancia de algunos factores de riesgo, actualmente la única premisa necesaria para indicar la cirugía es poder extirpar toda la enfermedad macroscópica con márgenes libres de tumor.
El objetivo de mejorar los índices de supervivencia ha de basarse en un tratamiento multidisciplinario: cirugía oncológica del tumor primario, seguimiento sistemático, estudio de extensión preoperatorio e intraoperatorio sensible y específico, procedimientos para el rescate quirúrgico, segundas resecciones y quimioterapia adyuvante. Esto sólo es posible si los pacientes con esta patología son referidos a centros con volumen, experiencia e infraestructura necesaria. Sólo así los resultados pueden cumplir y mejorar los estándares establecidos.
Palabras clave:
Metástasis hepaticas
Carcinoma colorrectal
Hepatic resection is the treatment of choice for patients with colorectal hepatic metastasis. Nowadays, 5 year survival rates of 25-40% are achieved. Although the role of some risk factors have been demonstrated, the only needed condition to indicate surgical resection is to be able to resect all macroscopic disease with free tumor margins.
The aim to improve the survival rates has to be based in a multidisciplinar treatment: oncological surgery of the primary tumor, systematic follow-up, precise preoperative and intraoperative extension study, surgical rescue procedures, second resections and adyuvant chemotherapy.
This procedure is only possible if patients with this pathology are refered to centers with enough volume, experience and infrastructure. Only with these requirements the results can achieve and improve the stablished standars.
Key words:
Hepatic metastases
Colorrectal carcinoma
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