Recent advances in the treatment of colorectal liver metastases

Abstract

Liver metastasis is the leading cause of death from colorectal cancer (CRC). Multidisciplinary team model has become standard strategy for the diagnosis and treatment of colorectal liver metastases (CRLM), making individuali-zed treatment through precise staging and molecular typing. Preoperative hepatic and regional arterial infusion chemotherapy and portal vein chemotherapy during surgery can reduce the incidence of liver metastases for stage Ⅲ CRC. Surgical resection of CRLM has been accepted by all scholars, and can be performed by minimally invasive surgery. The criteria for hepatic resection of CRLM have been extended including complete tumor resection, negative resection margin and adequate remnant liver volume. Simultaneous resections of primary tumor and liver metastases are safe and feasible. However, neoadjuvant chemotherapy is still controversial. For unresectable liver metastases, conversion therapy should be implemented to make the liver metastases become resectable. For unconvertible and unresectable CRLM, aggressive and comprehensive treatment is required to control the disease progression. Key words: Colorectal neoplasms; Liver metastases; Multidisciplinary team; Surgical indications