Hepatic colorectal metastasis: current status of surgical therapy

Metastatic colorectal cancer to the liver develops in over 50,000 US patients each year and is rapidly fatal if untreated. Even the most active chemotherapeutic agents rarely prolong survival for more than 3 years. Liver resection is the only potentially curative treatment, affording 5-year survival in one-third of patients. The only absolute contraindications to liver resection are poor general health, clear evidence of wide disease dissemination, or inability to resect all liver disease. Close follow-up is warranted after liver resection since disease recurs in two-thirds of patients and recurrences can be successfully treated, possibly with curative potential. Cryosurgery is a promising ablative modality that needs to be compared to chemotherapy but has not been proven to be curative.