Pre- or postoperative chemotherapy in patients with colorectal cancer with synchronous, resectable liver metastases?

Abstract

At the moment, there is no clear scientific data on the use of preoperative chemotherapy in patients with colorectal, synchronous, resectable liver metastases. Below arguments are presented against the use of preoperative chemotherapy in the above clinical situation, based on an analysis of three issues: the toxicity of preoperative chemotherapy and associated perioperative complications, the efficacy of pre- and postoperative chemotherapy, doubts related to the use of preoperative chemotherapy. To summarise, most scientific data is against preoperative chemotherapy as it causes significant adverse effects (hepatotoxicity and consequent postoperative complications) without a significant improvement in survival rates. Therefore, postoperative chemotherapy in this group of patients seems to be the more optimal treatment