Treatment of liver metastases from colorectal cancer: what is the best approach today?

Liver is the common site for metastases from colorectal cancer The 5-year o verall survival rate of patients following radical operations is 25%. Surge ry can be carried out in only 10-15% of the patients, yet it remains the po tential curative treatment for resectable lesions. For the unresectable can cers, only chemotherapy is recommended. New drugs such as Irinotecan prolon gs the overall survival of patients affected by advanced disease. In patien ts with unresectable metastases at diagnosis, pre-surgical treatment with O xaliplatin leads to reduction of the lesions, allowing resection in 16% of cases. Chemotherapy may be delivered directly into the liver via the hepati c artery. No, clinical trials, to date, have shown convincing survival resu lts in patients treated with this procedure. Combined hepatic artery and sy stemic treatment may provide a new strategy as adjuvant therapy for patient s undergoing resections.