Management of colorectal cancer metastases to the liver, lung or peritoneum suitable for curative intent: summary of NICE guidance

Abstract

The management of metastatic colorectal cancer has undergone a strategic evolution with improvements in imaging, biomarker-based selection for systemic anticancer therapy (SACT), and innovations in surgical and local ablative techniques. Since the concept of oligometastatic disease was introduced 1, the benefit of adding metastases-directed local therapy to standard-of-care systemic treatment has been unclear. Decision-making in these situations is often complex and dynamic, involving clinicians from a variety of specialties. The most common sites of metastases from colorectal cancer are the liver, lung and peritoneum. As part of the National Institute for Health and Care Excellence (NICE) guideline update for colorectal cancer 2 the Guideline Committee reviewed the evidence to support treatment decisions for patients with metastases to these sites. The evidence reviews and the methods used are available on the NICE website 2. Here, the key evidence behind the NICE guidance is highlighted.