After undergoing surgery for Carcinoma of the colon, a patient developed single liver metastasis of 2cm. What is the next line of management?
Total resection of the tumor is optimal management when a tumor is detected in the large bowel.The detection of metastases should not preclude surgery in patients with tumor-related symptoms.Radiation therapy to the pelvis is recommended to reduce the 20-25% probability of recurrence of stage II or III tumors after complete surgical resection.Preoperative radiotherapy is indicated for patients with large, potentially unresectable rectal cancers.Systemic therapy has become more effective.5-Fluorouracil remains the backbone of treatment of this disease. It acts as a radiosensitizer when delivered together with radiation therapy.FOLFIRI regimen: Irinotecan with 5-FU and Leucovorin.FOLFOX regimen: leucovorin with 5-FU and Oxaliplatin.MONOCLONAL ANTIBODIES: EGFR Ab -Cetuximab, Panitumumab, VEGF-Bevacimumab.Patients with solitary hepatic metastases without clinical or radiographic evidence of additional tumor involvement should be considered for paial liver resection.(Ref: Harrison's 18/e 773,774)
Resection
Chemoradiation
Acetic acid injection
Radiofrequency ablation
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