Surgical treatment of liver metastases of colorectal cancer: Strategies and controversies in 2006

• Published in: European journal of surgical oncology Vol. 32; no. 5; pp. 473 - 483
• Main Authors: Hao, C.Y., Ji, J.F.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2006
• Subjects: Antineoplastic Agents - therapeutic use; Clinical Protocols; Colonic Neoplasms - pathology; Colorectal cancer; Contraindications; Embolization, Therapeutic; Hepatectomy - methods; Humans; Laparoscopy; Liver metastases; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Liver resection; Neoadjuvant Therapy; Prognosis; Rectal Neoplasms - pathology; Liver metastases; Liver resection; Prognosis; Colorectal cancer
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2006.02.016

To review the latest strategies and controversies in the surgical treatment of liver metastases of colorectal cancer systemically and comprehensively. A medline based literature search on relevant topics was performed in PubMed for key articles concerning the novel strategies and controversies in the management of liver metastases of colorectal cancer. Some information was obtained from ‘Proc Am Soc Clin Oncol’ published recently. The findings and discussions were related to our own experiences. Although for well-indicated patients, a consensus has been reached that hepatic resection is the only management that could provide the patients curability, there still exist many controversies, such as the prognostic evaluation, contraindications to hepatic resection, treatment for synchronous liver metastases, the place of laparoscopic surgery, etc. Meanwhile, various strategies to improve the respectabilities are available, including neoadjuvant chemotherapy, portal vein embolization, two stage hepatectomy, and some locally ablative approaches. The current condition is difficult and sometimes confusing for a relevant surgeon when designing treatment protocols for more complex diseases. As the advancing of the management of liver metastases of colorectal cancer, more patients will become candidates for and benefit from potentially curative surgical resections. Optimal effect could only be achieved when used in a manner tailored to the individual patient