Developing strategies for liver metastases from colorectal cancer

Five-year survival rates of patients with liver metastases from colorectal cancer range from 30% to 40% for those who undergo successful resection procedures, and is almost nil among those unable to have surgery. However, improved chemotherapy strategies for nonoperable patients (specifically, the use of neoadjuvant oxaliplatin- and irinotecan-based regimens) have increased response rates and tumor downstaging such that 15% to 30% of initially nonoperable patients are able to have secondary, or rescue, surgery. Preliminary data also indicate that new targeted therapies should further increase response rates and thus resection rates. Operative techniques such as portal vein embolization and two-stage procedures for patients with multiple or large tumors, as well as use of cryosurgery and radiofrequency ablation, are also contributing to more effective removal of liver metastases from colorectal cancer. This brief report describes data supporting the expanding application of hepatectomy for patients with colorectal liver metastases.