Abstract
Liver resection with curative intent for metastastic disease can be performed at low operative morbidity and mortality (< 3%). Most data relate to colorectal metastases. Five year survival following primary and repeat liver resection is consistently reported as 25-30% and has not been improved by adjuvant chemotherapy. Options for improvement of prognosis by purely technical means appear limited. Instead, future strategies should aim at increasing the number of patients amenable to potentially curative liver resection. This could be achieved by earlier diagnosis, by combination of surgical resection with neoadjuvant treatment or thermoablation, by selective portal embolisation as well as further surgical specialisation. The search for effective adjuvant therapy should continue.
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