Surgery of hepatic metastases

5-year survival after liver resection for colorectal liver metastases is 20-30%. Several factors contribute to a short survival: 4 or more liver tumours, a tumour free margin less than 10 mm and the occurrence of extrahepatic metastases. The prognosis is not significantly less in bilateral as compared in unilateral disease provided that 3 or less tumours, no extrahepatic spread at the tumour free margin more than 10 mm can be achieved. No prognostic difference is seen between synchronous and metachronous metastases.