Surgery for colorectal liver metastases: expanding the boundaries but where have all the patients gone.
OBJECTIVE
To review and discuss the current strategies and controversies in the surgical management of colorectal cancer liver metastases.


METHODS
An analysis of indications, contraindications and scoring systems and concepts for expanding the indications for resection are discussed. The findings and discussion are related to our own experience, especially with radiofrequency assisted liver resection for colorectal cancer liver metastases.


RESULTS
Resection is the only management strategy that can potentially cure the patient. Certain controversies still exist, such as contraindications for surgery, timing of treatment of synchronous metastases, significance of extra-hepatic disease etc. Strategies that can improve respectability are discussed. Parenchyma oriented, tissue sparing surgery facilitates reresection should it become necessary.


CONCLUSIONS
The management of colorectal cancer liver metastases is still a confusing issue for general oncologists and general surgeons. A multidisciplinary approach that tailors the management strategy to the individual patient is the only option that provides optimal results for patients with advanced disease.
Milicevic
Miroslav
M
Institute for Digestive Disease, Clinical Center of Serbia, Belgrade.
Bulajic
Predrag
P
Zuvela
Marinko
M
Raznjatovic
Zoran
Z
Lekic
Nebojsa
N
Basaric
Dragan
D
Galun
Danijel
D
Barovic
Svetlana
S
D015179:Colorectal Neoplasms / Q000473:pathology*; D000075202:Contraindications; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*