Treatment of colorectal hepatic metastases

Hepatic metastases of colorectal carcinoma are present at diagnosis in 20 per cent of patients and occur within two years in 80 per cent of those which will recur in the liver. Surgical resection of all hepatic disease can confer survival on 20 per cent of resectable patients, but there is no other curative therapy. No systemic drug treatment has been shown superior to 5-FU alone, and the benefit of hepatic artery chemotherapy with FUdR (in contrast with systemic treatment) remains unproved. External beam radiation therapy with 3,000 rads offers effective palliation with low morbidity. The combination of chemotherapy with radiation treatment or hyperthermia may prove beneficial, but such protocols represent research rather than established treatment.