title: Colorectal liver metastases with extrahepatic disease--a new criteria for oncologic resection?
abstract: BACKGROUND
  Emerging data suggest that in the current era of modern systemic therapies, resection of colorectal liver metastases with concomitant extrahepatic disease may be a curative option in selected patients.
  
  
  METHODS
  A commentary of several key recent papers including an international multi-institutional registry study may provide directions in the future management of this disease entity.
  
  
  RESULTS
  The premise of selecting patients for a surgical approach to resect colorectal liver metastases and concomitant extrahepatic disease should be individualized. Incorporation of key prognostic factors that include the site of extrahepatic disease, the ability to undertake a complete resection, disease responding to chemotherapy, and an assessment of tumor biology through examining an individual's disease history may guide the selection of suitable patients for this therapeutic pursuit. A 5-year survival of 30% may be realized in well-selected patients.
  
  
  CONCLUSIONS
  Concomitant extrahepatic disease in patients with colorectal liver metastases should not be a contraindication to resection of colorectal cancer metastases.
authors.affiliation: Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery, St George Hospital and St George Clinical School, University of New South Wales, Kogarah, Sydney, NSW, 2217, Australia. terence.chua@unsw.edu.au
authors.forename: Terence C
authors.initials: TC
authors.lastname: Chua
authors.forename: David L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008207:Lymphatic Metastasis; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000601:surgery*; D011379:Prognosis