Abstract:
For patients with colorectal liver metastases, hepatic resection is the
treatment of choice, and the 5-year survival rate following surgery now
exceeds 50%. Timely multidisciplinary and multimodality approaches
that may include preoperative systemic chemotherapy, preoperative
portal vein embolization, extended hepatic resection, and two-stage
hepatectomy, have enabled a large proportion of patients to undergo
potentially curative treatment. The definition of resectability has shifted
from a focus on tumor characteristics, such as tumor number and size, to
determination of whether both intrahepatic and extrahepatic disease
can be completely resected and whether such an approach is appropriate
from an oncologic standpoint for a given patient. Future
identification of molecular factors may aid in predicting prognosis of
patients with colorectal liver metastases and in improving the selection
of patients most likely to benefit from surgery. Hepatobiliary surgeons
and medical oncologists should work together to individualize treatment
strategies to maximize long-term survival in patients with
colorectal liver metastases.
