Surgical management of metastatic cancer in the liver

Metastatic cancer to the liver from gastrointestinal primary should be treated with surgical resection as a first priority. Biological and physical restrictions on the dissemination of metastatic cancer result in disease dissemination isolated within the liver in selected patients. Although there are numerous prognostic features by which patients are selected for treatment, there is one overriding prognosticator that controls the decision-making process in these patients. If a patient can be made clinically disease free as a result of surgical removal of cancer from the liver, then this technical challenge should be undertaken. This surgical complete response can be expected to prolong the life of all patients made clinically disease free, and to result in survival in approximately 30% of the entire group. Regional and systemic treatment that will improve the results of a surgical complete response, need to be pursued.