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World J Gastroenterol. Sep 28, 2011; 17(36): 4067-4075
Published online Sep 28, 2011. doi: 10.3748/wjg.v17.i36.4067
Current treatment for colorectal liver metastases
Evangelos P Misiakos, Nikolaos P Karidis, Gregory Kouraklis
Evangelos P Misiakos, Third Department of Surgery, Medical School, University of Athens, Attikon University Hospital, Athens 12462, Greece
Nikolaos P Karidis, Gregory Kouraklis, Second Propedeutic Department of Surgery, Medical School, University of Athens, General Hospital Laiko, Athens 11527, Greece
Author contributions: Misiakos EP organized and prepared the draft of the present review; Karidis NP contributed to reference collection and final preparation of the manuscript; Kouraklis G coordinated and reviewed the manuscript.
Correspondence to: Nikolaos P Karidis, MD, General Surgeon, Second Propedeutic Department of Surgery, University of Athens, General Hospital Laiko, Athens 11527, Greece.
Telephone: +30-69-74779016 Fax: +30-21-07791456
Received: October 3, 2010
Revised: November 30, 2010
Accepted: December 7, 2010
Published online: September 28, 2011

Surgical resection offers the best opportunity for survival in patients with colorectal cancer metastatic to the liver, with five-year survival rates up to 58% in selected cases. However, only a minority are resectable at the time of diagnosis. Continuous research in this field aims at increasing the percentage of patients eligible for resection, refining the indications and contraindications for surgery, and improving overall survival. The use of surgical innovations, such as staged resection, portal vein embolization, and repeat resection has allowed higher resection rates in patients with bilobar disease. The use of neoadjuvant chemotherapy allows up to 38% of patients previously considered unresectable to be significantly downstaged and eligible for hepatic resection. Ablative techniques have gained wide acceptance as an adjunct to surgical resection and in the management of patients who are not surgical candidates. Current management of colorectal liver metastases requires a multidisciplinary approach, which should be individualized in each case.

Keywords: Colorectal liver metastases, Multidisciplin-ary treatment