Current Management of Colorectal Cancer with Liver Metastasis

Colorectal cancer is a worldwide public health problem. More than 20% of patients with colorectal cancer present at an advanced stage, and the liver is the most common site of metastases. More recently, selection criteria for resectability have been expanded, but definition of resectability still remains challenging. Since the presence of metastases is the most relevant prognostic factor, surgical resection of liver metastases is the mainstay of treatment. The most appropriate resection approach remains controversial, but both staged and simultaneous resection has been shown to have comparable survival advantages and long-term outcomes. The advent of new chemotherapeutic agents and the development of loco-regional therapies (embolization, ablation, and infusion chemotherapy) have contributed to better outcomes. It is deemed reasonable to adopt combination therapy for unresectable metastases. In view of the lack of standardized evidence-based protocols, optimal management of hepatic metastases should be individualized to the single patient and decided through a multidisciplinary approach. Early detection is always the ultimate goal to reduce metastatic colorectal cancer burden worldwide. In this overview, the current management of liver metastases originating from colorectal cancer is presented.