Review
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World J Gastrointest Surg. May 27, 2013; 5(5): 138-145
Published online May 27, 2013. doi: 10.4240/wjgs.v5.i5.138
Management of potentially resectable colorectal cancer liver metastases
Fausto Meriggi, Paola Bertocchi, Alberto Zaniboni
Fausto Meriggi, Paola Bertocchi, Alberto Zaniboni, Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, 25124 Brescia, Italy
Author contributions: Meriggi F, Bertocchi P and Zaniboni A contribuited equally to this paper.
Correspondence to: Alberto Zaniboni, MD, Oncology Department, Istituto Ospedaliero Fondazione Poliambulanza, via Bissolati 57, 25124 Brescia, Italy. zanib@numerica.it
Telephone: +39-30-3515553 Fax: +39-30-35152224
Received: February 24, 2013
Revised: March 28, 2013
Accepted: April 27, 2013
Published online: May 27, 2013
Abstract

Colorectal cancer is a very common malignancy worldwide and development of liver metastases, both synchronous or metachronous, is a common event. Of all patients with metastatic colorectal cancer, up to 77% have a liver-only disease and approximately 10%-20% of patients with colorectal liver metastases are considered resectable at the time of diagnosis. Surgical resection of liver metastases remains the best treatment option and it is associated with a survival plateau and a 20%-25% of long-term survivors. Perioperative chemotherapy for resectable liver metastases may improve resecability of liver metastases and disease free survival, but its impact on overall survival is still unclear and more studies are needed. Moreover, preoperative chemotherapy can increase postoperative complications. Further studies are needed to define the role of adjuvant chemotherapy after a R0 resection of liver metastases and to define the criteria for a better selection of patients candidate to hepatectomy. New strategies such as targeted therapies are emerging with promising results. Optimal management requires a multidisciplinary approach, local and systemic, but it is a still pending question. Colorectal liver metastases represent a major challenge for oncologists and surgeons. In this review will be analyzed available data about assessment and management of the patients with potentially resectable colorectal liver metastases.

Keywords: Colorectal cancer, Liver metastases, Perioperative chemotherapy, Surgical resection, Targeted therapies

Core tip: Colorectal cancer is a very common malignancy and its incidence is rapidly increasing worldwide. Of all patients with metastatic colorectal cancer, up to 77% have a liver-only disease and about 10%-20% of them are considered resectable at the time of diagnosis. Surgery actually still represents the best option of treatment, but new strategies such as perioperative chemotherapy and targeted therapies are emerging with promising results. However, optimal management requires a multidisciplinary approach, both local and systemic. This review aims to critically analyze the management of potentially resectable colorectal liver metastases.