Surgical management of colorectal metastases to the liver

Liver metastases develop in 50% to 60% of patients with colorectal carcinoma. Surgical resection offers a good five-year survival rate and the only chance of cure. In this article, the natural history and risk factors for the development of colorectal liver metastases are discussed, followed by the diagnostic work-up towards surgical resection. Various issues pertaining to surgical management, such as patient selection, timing of resection, perioperative mortality and morbidity, prognostic factors, adjuvant and neoadjuvant therapy and repeat resection are reviewed.