[Chemotherapy of liver metastasis from colorectal cancer]

Radical hepatectomy-- the only curative treatment for colorectal liver metastasis--is feasible in 75 to 85% of cases. In 1990 we showed that chemotherapy rendered some otherwise unresectable colorectal liver metastases resectable. We have now treated more than 200 such patients, with respective 5-year and 10-year overall survival rates of 30% and 18%. This difficult surgery involves major hepatectomy in 55% of patients, repeat hepatectomy (up to four procedures) in 36% of patients, and associated pulmonary resection in 20% of patients. We have also pioneered the use of presurgical liver parenchyma augmentation, in order to permit major hepatectomy without risking post-operative liver failure due to inadequate parenchymal tissue. New medical treatments, including monoclonal antibodies against tumoral growth factors (cetuximab) and vascular growth factors (bevacizumab), are also proving useful for tumor shrinkage prior to surgical resection.