NEW TRENDS IN THE SURGICAL-TREATMENT OF COLORECTAL-CANCER LIVER METASTASES

Colorectal cancer is one of the most common solid tumors affecting peo ple around the world. A significant proportion of patients with colore ctal cancer will develop or will present with liver metastases, In som e of these patients, the liver is the only site of metastatic disease, Thus, surgical treatment approaches are an appropriate and important treatment option in patients with liver-only colorectal cancer metasta ses. Resection of colorectal cancer liver metastases can produce long- term survival in selected patients, but the efficacy of liver resectio n as a solitary treatment is limited by two factors, First, a minority of patients with liver metastases have resectable disease, Second, th e majority of patients who undergo successful liver resection for colo rectal cancer metastases develop recurrent disease in the liver, extra hepatic sites, or both, In this paper, in addition to the results of l iver resection for colorectal cancer metastases, we will review the re sults of cryoablation, heat ablation, and hepatic arterial chemotherap y using a surgically implanted pump. Each of these surgical treatment modalities can produce long-term survival in a subset of patients with liver-only colorectal cancer metastases, whereas systemic chemotherap y used alone rarely results in long:term survival in these patients, W hile surgical treatments provide the best chance for long-term surviva l or, In some cases, the best palliation in patients with colorectal c ancer liver metastases, it is clear that further improvements in patie nt outcome will require multimodality therapy regimens.