Liver-directed therapies in colorectal cancer

Colorectal cancer is the third leading cause of cancer-related deaths in the United States. Historically, the majority of patients that presented with metastatic disease to the liver were treated with systemic chemotherapy only but advances in imaging, surgical techniques, and non-resectional approaches have expanded the indications for liver-directed interventions. Current approaches used in patients with liver-only or liver-dominant metastatic disease include surgical resection, direct tumor ablation strategies, the use of intra-arterial infusions, and radiation therapies. The use of these liver-directed therapies in selected patients with colorectal liver metastases has led to significant improvements in overall survival. We review the clinical data and progress using liver-directed therapies in the treatment of colorectal liver metastases.