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Letter to the Editor|Articles in Press

Response to Professor Siriwardena regarding our manuscript A comparison of the simultaneous, liver-first, and colorectal-first strategies for surgical treatment of synchronous colorectal liver metastases

Published:March 18, 2023DOI:https://doi.org/10.1016/j.hpb.2023.03.009
      We thank Professor Siriwardena and colleagues for their valuable comments on our manuscript.
      • Fruhling P.
      • Stromberg C.
      • Isaksson B.
      • Urdzik J.
      A comparison of the simultaneous, liver-first, and colorectal-first strategies for surgical treatment of synchronous colorectal liver metastases at two major liver-surgery institutions in Sweden.
      It seems like we share the view that arranging a randomized controlled trial for patients with colorectal cancer and synchronous liver metastases is hard, if not unfeasible. We are happy to see that the authors highlight our algorithmic approach to patient selection in devising a treatment plan. Finally, we agree with Professor Siriwardena and colleagues, that treatment decisions in the future will be more influenced by an in-depth knowledge of the biology of the primary cancer, and perhaps also the biology of the metastases. Recent developments in spatial transcriptomics point towards a more precision based medicine.
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      Reference

        • Fruhling P.
        • Stromberg C.
        • Isaksson B.
        • Urdzik J.
        A comparison of the simultaneous, liver-first, and colorectal-first strategies for surgical treatment of synchronous colorectal liver metastases at two major liver-surgery institutions in Sweden.
        HPB. 2022;