title: Recent Advances in Chemotherapy and Surgery for Colorectal Liver Metastases.
abstract: BACKGROUND
  The liver is the most common site of metastases for colorectal cancer, and combined resection with systemic chemotherapy is the most effective strategy for survival. The aim of this article is to provide a comprehensive summary on four hot topics related to chemotherapy and surgery for colorectal liver metastases (CLM), namely: (1) chemotherapy-related liver injuries: prediction and impact, (2) surgery for initially unresectable CLM, (3) the emerging role ofRASmutations, and (4) the role of hepatic arterial infusion of chemotherapy (HAIC).
  (1) The use of chemotherapy before liver resection for CLM leads to drug-specific hepatic toxicity, which negatively impacts posthepatectomy outcomes. (2) Curative liver resection of initially unresectable CLM following conversion chemotherapy should be attempted whenever possible, provided that a safe future liver remnant volume is achieved. (3) For CLM,RASmutation status is needed to guide the use of targeted chemotherapy with anti-epithelial growth factor receptor (EGFR) agents, and is a major prognostic factor that may contribute to optimize surgical strategy. (4) HAIC agents increase the rate of objective response and the rate of complete pathological response.
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Passot
authors.affiliation: Department of HPB Surgery, Beaujon Hospital, Clichy, France, Villejuif, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Soubrane
authors.affiliation: Hepato-Biliary Surgery Unit, Foundation Policlinico Universitario Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Giuliante
authors.affiliation: Hepato-Biliary Surgery Unit, Foundation Policlinico Universitario Agostino Gemelli, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Zimmitti
authors.affiliation: Department of Surgical Oncology, Gustave Roussy, Villejuif, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Goéré
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
authors.forename: Suguru
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Vauthey
keywords: Chemotherapy-related liver injuries; Colorectal cancer; Colorectal liver metastases; Hepatic arterial infusion of chemotherapy; RAS mutation status