[Surgical treatment of liver metastases from colorectal cancer].
BACKGROUND
The liver is the most common location for metastases from colorectal cancer. Current treatment options (i.e. neo-adjuvant chemotherapy, pre-operative portal vein embolization), IMPROVED OPERATIVE TECHNIQUES: and combinations of modalities and have rendered more patients eligible for liver surgery.


METHODS
Literature from 1996 to July 2007 was retrieved from Pubmed using the search terms "liver metastases", "liver resection", "colorectal cancer", "randomized controlled trial", "systematic review" and "meta-analysis".


RESULTS
No randomized controlled trials were identified that compared liver resection with non-surgical treatment of these patients. Except for a few systematic review articles, the scientific basis for resection of liver metastases from colorectal cancer consists mainly of retrospective studies from single institutions. Median survival for patients with colorectal liver metastases is about 20 months; a five-year survival of 30-50% is reported in resected patients. Patients with non-resectable disease rarely survive for five years. 30-40% of the resected patients have post-operative complications (mostly minor) and postoperative mortality is 3-5%.


CONCLUSIONS
Surgical treatment of liver metastases is established practice. Patients with colorectal liver metastases should be referred to a multidisciplinary team for appropriate evaluation. Neoadjuvant treatment and multimodal approaches may increase the proportion of patients with resectable liver metastases, and better preoperative imaging may help to more carefully select patients who can benefit from this treatment.
Søreide
Jon Arne
JA
Kirurgisk avdeling, Stavanger universitetssjukehus, 4068 Stavanger. jon.soreide@kir.uib.no
Eiriksson
Kristinn
K
Sandvik
Oddvar
O
Viste
Asgaut
A
Horn
Arild
A
Johnsen
Gjermund
G
Grønbech
Jon Erik
JE
D015179:Colorectal Neoplasms / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D010347:Patient Care Planning; D010348:Patient Care Team; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome