Management of Liver Metastasis of Colorectal Cancers

Abstract

Colorectal cancer (CRC) is the third most commonly diagnosed malignancy accounting for 11% of cancers in men and women and also is the third leading cause of cancer mortality each year (Berenson et al., 2006). Among patients who have CRC, a majority will eventually develop liver metastases. In 30% to 40% of CRC patients, metastases are confined to the liver when they are initially found (Penna et al., 2006). The development of metastases is the main cause of death. Liver metastases are diagnosed in10–25% of patients at the time of resection of their primary colorectal tumor (Welch et al., 1997). Patients with liver metastases from colorectal cancer should be evaluated by experienced surgeons and radiologists and oncologists as the treatment can include multimodalities (Primrose et al., 2000). Hepatic resection is the gold standard in the treatment of colorectal liver metastases, and it is the only curative option in patients with hepatic metastases from CRC is margin-free resection where the 5-year overall survival rates in selected cases range from 37 to 58%. In the case of synchronous metastases, the primary tumour must always be operated on if symptomatic, irrespective of the resectability of the metastases. Standard practice remains to resect the primary and metastases together or resect the primary and the metastases in a stepwise fashion followed by adjuvant chemotherapy (McLoughlin et al., 2006).