TREATMENT OF COLORECTAL-CANCER METASTASES CONFINED TO THE LIVER

Hepatic metastases are a major cause of death in patients with dissemi nated colorectal cancer. The prognosis of patients with hepatic metast ases is very poor and mainly determined by the extent of hepatic disea se at presentation. In these patients, the goal of any treatment is to obtain a complete tumour remission in the liver; this is the only way to obtain a significant survival benefit. In this overview, we summar ise data from (i) studies comparing survival of patients after primary resection of liver metastases with survival after repeat liver resect ions, (ii) studies comparing hepatic arterial infusion of fluoropyrimi dines with systemic delivery of these anticancer drugs, and (iii) phas e I/II studies on isolated liver perfusion (ILP) with alkylating compo unds. Furthermore, we discuss alternative strategies to combat liver m etastases, including those taking advantage of an ILP setting.