title: [Surgical treatment of liver metastases from colorectal cancer].
abstract: 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.
authors.affiliation: Kirurgisk avdeling, Stavanger universitetssjukehus, 4068 Stavanger. jon.soreide@kir.uib.no
authors.forename: Jon Arne
authors.initials: JA
authors.lastname: Søreide
authors.forename: Kristinn
authors.initials: K
authors.lastname: Eiriksson
authors.forename: Oddvar
authors.initials: O
authors.lastname: Sandvik
authors.forename: Asgaut
authors.initials: A
authors.lastname: Viste
authors.forename: Arild
authors.initials: A
authors.lastname: Horn
authors.forename: Gjermund
authors.initials: G
authors.lastname: Johnsen
authors.forename: Jon Erik
authors.initials: JE
authors.lastname: Grønbech
mesh_terms: 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