Treating Liver Metastases: Saving Lives
Treating Liver Metastases: Saving Lives was launched at the Association of Surgeons of Great Britain and Ireland on 13 May 2011. The pathway aims to tackle significant variations in the treatment of bowel cancer patients with metastases in the liver by standardising the procedures for multidisciplinary team assessment and treatment planning for patients.
Over the past few years, the treatment options for patients with metastatic colorectal disease have been steadily improving. The latest figures published suggest that for patients with liver limited metastases, the outcomes have recently improved by 1000% (Presented by Poston, G. at ASGBI Conference, 2011). This is, in no small part, a reflection of the real potential of the TA176 guideline from NICE in 2009 recommending the use of cetuximab (Erbitux) as a first line treatment for K-RAS wild type colorectal cancers with liver limited disease. However, when the data from the cancer registries is broken down into patient outcomes by region, significant variations exist across the UK in the way this guidance is being applied, suggesting unacceptable inequality in the decision making processes influencing access to the most appropriate treatments.
In recognising this uncertainty and variation in the way patients are being managed from region to region across England, Beating Bowel Cancer developed a “best practice” liver metastases treatment pathway. The final presentation of the pathway was reached through an extensive collaboration of more than 50 expert clinicians, representing the whole spectrum of colorectal, oncology and liver multi-disciplinary teams from across the UK.
For the healthcare professional working with these patients , this pathway offers guidance on what is considered to be the UK standard of best practice for the efficient and effective management of metastatic colorectal disease. As such, it can simplify potentially difficult conversations by answering the “what next?” questions in a clear, unequivocal way. It can also be used to provide a visual representation of the patients options, by describing what the sequence of events on their pathway will be, and help them to understand which pathway has the greatest potential for both quality of life and outcome, according to their own individual circumstances.