MANAGEMENT STRATEGIES FOR COLORECTAL LIVER METASTASES .1.

Colorectal cancer is a common malignancy and the incidence of this dis ease is increasing. Approximately 50% of patients with colorectal canc er die from recurrent disease following an apparently curative resecti on of the primary tumour and the liver is the most frequent site of re lapse, Although only a small proportion of patients will benefit from resection of liver metastases, this form of treatment offers the only possibility of cure, In selected patients, 5-year survival rates of 25 -35% may be achieved following liver resection. A poor prognosis after resection of hepatic metastases is likely when there are more than th ree metastatic deposits, involved resection margins often as a result of 'wedge' resections, when there is extrahepatic disease, or when the re is nodal involvement at the primary tumour site, Regional hepatic a rtery infusion chemotherapy may provide palliation and possibly even p rolongation of survival for some patients with unresectable metastases . Cytoreductive techniques may also provide palliation in selected pat ients with hepatic metastases unsuitable for resection; cryotherapy is the most promising of these methods. (C) 1997 Elsevier Science Ltd.