title: [Liver metastases from colorectal cancer. Is the practice of surgery based on the best clinical evidence possible?].
abstract: To date, surgical resection remains the only curative treatment for liver metastases from colorectal cancer. However, the evidence supporting this treatment is based on retrospective studies. The lack of level I clinical evidence has stimulated strong interest in identifying the factors predictive of recurrence, and even to use them to create clinical risk scores (assigning one point to each factor for poor prognosis), in which a higher score indicates a poorer prognosis. In the present review, we discuss all these factors, as well as the therapeutic alternatives that improve local disease control. Next, we review all the prospective randomized studies published on this topic, which mainly focus on adjuvant chemotherapy associated with curative surgery with negative margins, with the aim of validating or rejecting this treatment. Lastly, we include the algorithm of the University of California at San Francisco for surgery in liver metastases from colorectal cancer.
authors.affiliation: Departamento de Cirugía, Universidad de Alcalá (UAH), Alcalá de Henares, Madrid, Spain. hipdur@teleline.es
authors.forename: Hipólito
authors.initials: H
authors.lastname: Durán Giménez-Rico
authors.forename: Julio
authors.initials: J
authors.lastname: García-Aguilar
authors.forename: Robert S
authors.initials: RS
authors.lastname: Warren
authors.forename: Purificación
authors.initials: P
authors.lastname: Iborra
authors.forename: Víctor
authors.initials: V
authors.lastname: Guerrero
mesh_terms: D000465:Algorithms; D015179:Colorectal Neoplasms / Q000473:pathology*; D019317:Evidence-Based Medicine; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D011379:Prognosis