Interventional therapy of colorectal liver metastasis

Abstract

Colorectal liver metastasis (CRLM) is one of the most difficult and key points in the treatment of colorectal cancer. Approximately 50% to 60% of patients diagnosed as colorectal cancer develops metastasis, and 80% to 90% of CRLM is unresectable. Surgical resection is the first-line treatment for CRLM, while it is only suitable for about 15% patients. Systemic chemotherapy can prolong the survival of CRLM patients, however, a part of CRLM patients are resistant to chemotherapy. With the development of technology and the update of clinical evidence, individual therapy with target drugs and multidisciplinary treatment (MDT) have became a tendency, and minimally invasive interventional therapy has gained more acceptance in the MDT mode of the treatment for CRLM. Basically, the interventional treatment for CRLM is divided into two groups: vascular intervention and local minimally invasive intervention. Vascular approaches encompass portal vein embolization (PVE), hepatic artery infusion chemotherapy (HAIC), transarterial chemoembo- lization (TACE), and transarterial radioembolization (TARE). Local minimally invasive intervention includes radiofrequency ablation (RFA), microwave ablation(MWA), cryoablation (CRA), and irreversible electroporation (IRE). Thevefore intervention treatment is an important complement to the comprehensive therapy of CRLM.