Review
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World J Hepatol. Jul 27, 2014; 6(7): 453-463
Published online Jul 27, 2014. doi: 10.4254/wjh.v6.i7.453
Colorectal hepatic metastasis: Evolving therapies
Francisco Igor B Macedo, Tafadzwa Makarawo
Francisco Igor B Macedo, Tafadzwa Makarawo, Department of Surgery, Providence Hospital and Medical Centers, Southfield, MI 48075, United States
Author contributions: Macedo FI and Makarawo T contributed equally in all steps of this paper.
Correspondence to: Francisco Igor B Macedo, MD, Department of Surgery, Providence Hospital and Medical Centers, 16001 W Nine Mile Rd, Southfield, MI 48075, United States. franciscoigor.macedo@stjohn.org
Telephone: +1-786-9994754 Fax: +1-786-9994754
Received: November 28, 2013
Revised: February 23, 2014
Accepted: May 31, 2014
Published online: July 27, 2014
Abstract

The approach for colorectal hepatic metastasis has advanced tremendously over the past decade. Multidrug chemotherapy regimens have been successfully introduced with improved outcomes. Concurrently, adjunct multimodal therapies have improved survival rates, and increased the number of patients eligible for curative liver resection. Herein, we described major advancements of surgical and oncologic management of such lesions, thereby discussing modern chemotherapeutic regimens, adjunct therapies and surgical aspects of liver resection.

Keywords: Colorectal cancer, Hepatic metastasis, Hepatectomy, Survival, Chemotherapy, 5-fluorouracil leucovorin and oxaliplatin

Core tip: The management of colorectal hepatic metastasis is complex, and should involve a multidisciplinary tumor board involving specialized medical and surgical oncologists. Although liver resection still remains as the key step in the management of liver metastasis, the introduction of new chemotherapeutic regimens and recent adjunct therapies, including radiofrequency ablation, cryotherapy and radioembolization improved patient care, and prolonged survival in patients with unresectable disease.