Current Surgical Management of Colorectal Cancer Liver Metastases: A Mini Review

Background: Colorectal cancer is responsible for 10% of cancer related deaths and is the third most common cancer type in men and the second in women. Metastatic disease will develop in nearly 60% of patients with colorectal cancer, half of which will be located in the liver. At least 30% of the patients who underwent potentially curative primary tumor resection have liver micrometastases. Data sources: A PubMed search of relevant articles published up to 2010 was performed to identify current information about colorectal liver metastases regarding diagnosis and management with emphasis to surgery. Results: Hepatectomy is the only potentially curative option resulting in 5-year survival for one third of the patients, but only 10-30% of the patients are suitable for a radical procedure. Indications include ability to resect the tumor without residual disease, with removal of at least 1 cm of healthy tissue and clear margins, and the absence of extrahepatic metastatic disease. Specialized centers achieve mortality rate less than 5% and morbidity 20-50%. 5-year survival following hepatic resection is 25-40% with mean survival of 28-40 months. Conclusion: Current management of colorectal cancer liver metastases requires a multidisciplinary approach. Operative strategies and novel techniques that achieve wider excision areas with minimal blood loss make hepatectomy safe and effective.