Management of hepatic metastasis from colorectal cancers: an update

J Hepatobiliary Pancreat Surg. 2008;15(6):570-80. doi: 10.1007/s00534-008-1350-x. Epub 2008 Nov 7.


Approximately 50%-60% of patients with colorectal cancers will develop liver lesions in their life span. Despite the potential of surgical resection to provide long-term survival in this subset of patients, only 15%-20% are found to be resectable. The introduction of new neoadjuvant chemotherapeutic agents and the expanding criteria of resection have enhanced the overall 5-year survival from 30% to 60% in the past decade. The use of technical innovations such as staged resection; portal vein embolization, and repeat resection have allowed higher resection rates in patients with bilobar disease. Extrahepatic primary and liver-exclusive recurrent disease no longer represent an absolute contraindication to resection. The role of regional therapy using hepatic arterial infusion is being redefined for liver-exclusive unresectable disease. Adjuvant chemotherapy in combination with regional therapies is being looked at from fresh perspectives. Ablative approaches have gained a firm role both as an adjunct to surgical resection and in the management of patients who are not surgical candidates. Overall, the management of hepatic metastasis from colorectal cancers requires a multimodal approach.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Catheter Ablation
  • Chemotherapy, Adjuvant
  • Chemotherapy, Cancer, Regional Perfusion
  • Colorectal Neoplasms / pathology*
  • Combined Modality Therapy
  • Diagnostic Imaging
  • Embolization, Therapeutic
  • Humans
  • Laparoscopy
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Neoplasm Staging


  • Antineoplastic Agents