Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12391
Revised: January 30, 2014
Accepted: May 29, 2014
Published online: September 21, 2014
Colorectal cancer (CRC) is one of the commonest cancers with 1.2 million new cases diagnosed each year in the world. It remains the fourth most common cause of cancer-related mortality in the world and accounts for > 600000 cancer-related deaths each year. There have been significant advances in treatment of metastatic CRC in last decade or so, due to availability of new active targeted agents and more aggressive approach towards the management of CRC, particularly with liver-only-metastases; however, these drugs work best when combined with conventional chemotherapy agents. Despite these advances, there is a lack of biomarkers to inform us about the accurate management of the patients with metastatic CRC. It is therefore imperative to carefully select the patients with comprehensive multi-disciplinary team input in order to optimise the management of these patients. In this review we will discuss various treatment options available in management of colorectal liver metastases with potential guidance on how and when to choose these options along with consideration on future directions in management of this disease.
Core tip: Colorectal cancer is one of the commonest cancers in the world. The management of metastatic colorectal cancer has changed significantly in last decade or so; primarily based on better understanding of the molecular complexity of colorectal cancer coupled with aggressive approach in management of colorectal liver metastases. Colorectal liver metastasises were once considered as incurable disease but with better treatment options and valuable input from multi-disciplinary teams, this disease can be cured in a proportion of patients. This review takes into account various clinical scenarios and their complexity that the clinicians may face during management of this disease.