Towards personalised treatment of patients with colorectal liver metastases

Colorectal cancer is one of the most common types of cancer in our country and is yearly diagnosed in about 13,700 Dutch people. This type of cancer has good outcomes in the early stages, but patients with metastatic disease need to be studied to increase their chance of survival. Joost Hof, doctor in the departments of Genetics and Surgery of the UMCG, studied a large group of patients with colorectal liver metastases in his thesis. He found that a treatment in which a needle was placed into the liver metastases which burns until the cancer cells are destroyed had equal survival outcomes compared to the ‘classic’ treatment of a partial liver resection. Moreover, the needle treatment is less burdensome for patients compared to classic surgery. In some patients, the cancer quickly recurs after initial treatment. Hof studied tumor and patient characteristics that might make it possible to perform an upfront prediction whether patients quickly develop recurrent disease. These patients might be offered a more aggressive type of treatment. The presence of certain immune cells (B cells) and certain abnormalities in tumor DNA (like loss of chromosome 22) were found to be associated with patient survival. These findings are important for the further development of a good predictor of survival in patients with metastatic colorectal cancer.