Behind The Knife: The Surgery Podcast

You’re faced with a challenging case of a patient with rectal cancer and synchronous liver lesion. Where do you start: chemotherapy, chemoradiotherapy, upfront surgery, liver first, rectum first?  Join Drs. Carole Richard, François Dagbert and Maher Al Khaldi as they discuss the management of a patient with rectal cancer with a synchronous hepatic metastasis.  Learning objectives In this episode, we discuss the workup of a rectal tumour associated with synchronous liver metastases, indications for resection of the hepatic lesion, neoadjuvant and adjuvant treatment modalities, survival benefit of resection and patient follow-up.   Reference list: Moulton C-A, Gu C-S, Law CH, Tandan VR, Hart R, Quan D, et al. Effect of PET Before Liver Resection on Surgical Management for Colorectal Adenocarcinoma Metastases: A Randomized Clinical Trial. JAMA. 2014;311(18):1863–9. Bahadoer RR, Dijkstra EA, Etten B van, Marijnen CAM, Putter H, Kranenbarg EM-K, et al. Short-course radiotherapy followed by chemotherapy before