Sequential Hepatic Metastasectomy in Oligometastatic Colorectal Cancer
Keywords:
Colorectal Neoplasms; Liver Metastases; Oligometastatic Disease; HepatectomyAbstract
Introduction:Colorectal cancer is one of the leading causes of cancer-related mortality worldwide. Although a significant proportion of patients present with metastatic disease at diagnosis, the concept of oligometastatic disease has enabled the identification of a subgroupp otentially amenable to curative-intent treatment through multimodal strategies.
Objetive: To describe the clinical, surgical and molecular aspects of a patient with sigmoid colon adenocarcinoma with oligometastatic liver metastases.
Case presentation: We report the case of a 55-year-old male patient with sigmoid colon adenocarcinoma whop resented with rectal bleeding. Initial staging revealed oligometastatic liver disease without extra hepatic involvement. Molecular analysis demonstrated proficient mismatch repair (pMMR) status and a KRAS p.G12A mutation. The patient received perioperative chemotherapy with capecitabine and oxaliplatin, achieving a significant partial response. Subsequently, a two-stage surgical strategy was performed, including hepatic metastasectomy with complementary ablation, followed by laparoscopic resection of the primary tumor. Histopathological analysis confirmed a moderately differentiated adenocarcinoma without lymphnode involvement and a positive vascular margin in thehepaticresection. The clinical course was favorable, with good tolerance to adjuvant therapy, normalization of carcinoembryonic antigen levels, and no evidence of disease progression during early follow-up.
Discussion: This case highlights the value of a multidisciplinary approach in patients with oligometastatic colorectal cancer totheliver, emphasizing the role of perioperative chemotherapy as a tool for biological selection and the feasibilityof a two-stage surgical approach even in thepresence of adverse prognostic factors.
Conclusion: In carefully selected patients, multimodal treatment may provide encouraging oncological outcomes in oligometastati ccolorectal liver metastases.
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Copyright (c) 2026 Roberto Lázaro Blanco Sosa, Oscar Israel Delgado Rodriguez , Carlos David Garcia Martin, Milton Manuel Sanchez Garcia
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