Is There a Chance of Cure for Colorectal Liver Metastases?

Abstract

The liver is the most common site for metastatic spread from colorectal cancer with up to 50% of patients developing liver metastases during the course of their disease. Liver resection is the most effective treatment to achieve long-term survival and the only approach to obtain a potential cure for patients with colorectal liver metastases. R0 resectability criteria are not well established and these must be decided within a multidisclinary committee. Unfortunately, only few patients are amenable for surgery. The role of chemotherapy in colorectal liver metastases aims to decrease tumor size, to control micrometastatic disease and to identify groups of patients that might benefit from liver resection. Moreover, chemotherapy can convert some irresectable metastases into resectable ones. We must consider chemotherapy before surgery in patients with resectable colorectal liver metastases and bad prognostic factors and in those cases of potential resectability. Other liver-directed therapies must be reserved for unresectable disease without curative aims.