Dr Pascal Gervaz

Chirurgien FMH, chirurgie interne & chirurgie viscérale



Treatment Strategies for the Management of Advanced Colorectal Liver Metastases Detected Synchronously With the Primary Tumour




by Mentha G, Majno P, Terraz S, Rubbia-Brandt L, Gervaz P, Andres A, Allal AS, Morel P, Roth AD.




The review summarises the contributions of chemotherapy, interventional radiology and surgery to the improved survival observed in patients with colorectal liver metastases. The rationale in favour of modern neoadjuvant chemotherapy regimens, of pro-generative manoeuvres to increase the volume of the future remnant liver, and of resection techniques that preserve its function is discussed. For advanced synchronous colorectal metastases, the arguments in favour of a reversed approach with systemic chemotherapy, liver surgery and colon surgery in that order, as opposed to the traditional approach of colon surgery first, or to a simultaneous liver and large bowel resection, are presented.



in European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 2007 Dec; 33 Suppl 2:S76-83.