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27. 28. 29. 30. 31. 25 Kulinna C, Helmberger T, Kessler M et al (2001) Verbesserung der Diagnostik von Lebermetastasen mit der Multi-Detektor-CT. Radiologe 41:16–23 Van Hoe L, Baert AL, Gryspeerdt S (1997) Dual-phase helical CTof the liver: value of an early-phase acquisition in the differential diagnosis of noncystic focal lesions. Am J Roentgenol 168:1185–1192 Padovani B, Lecesne R, Raffaelli C et al (1996) Tolerability and utility of mangafodipir trisodium injection (MnDPDP) at the dose of 5 μmol/kg body weight in detecting focal liver tumors: results of a phase III trial using an infusion technique.

Thereafter, any combination of preoperative prognostic factors should be used not to deny liver surgery but to enroll high-risk patients in trials of peri-operative chemotherapy. However, Adam et al. reported that tumor progression in patients on neoadjuvant chemotherapy for resectable colorectal liver metastases should be considered an absolute contraindication to liver resection since it is associated with a poor outcome (8% at 5 years) [10]. More recently, data analyzed from the LiverMetSurvey international registry confirmed that tumor progression during chemotherapy is a negative prognostic factor but not an absolute contraindication to liver resection: the 5-year survival rate after liver resection was 35% in the progression group vs.

10. 11. 12. 13. 14. 15. 16. 17. Wagner JS, Adson MA, Van Heerden JA et al (1984) The natural history of hepatic metastases from colorectal cancer. A comparison with resective treatment. Ann Surg 199:502-507 Fortner JG, Silva JS, Golbey RB et al (1984) Multivariate analysis of a personal serie of 247 consecutive patients with liver metastases from colorectal cancer. Treatment by hepatic resection. Ann Surg 199:307-316 Scheele J, Stangl R, Altendorf-Hofmann A (1990) Hepatic metastases from colorectal carcinoma: impact of surgical resection on the natural history.

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ATLS. Programa avanzado de apoyo vital en trauma para medicos


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