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Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2018; 6(14): 716-734
Published online Nov 26, 2018. doi: 10.12998/wjcc.v6.i14.716
Current status of surgical treatment of colorectal liver metastases
Feng Xu, Bin Tang, Tian-Qiang Jin, Chao-Liu Dai
Feng Xu, Bin Tang, Tian-Qiang Jin, Chao-Liu Dai, Department of Hepatobiliary and Splenic Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Dai CL and Xu F contributed to the study conception and design; Xu F, Tang B and Jin TQ performed the literature search and wrote the main manuscript text; Dai CL provided advice regarding the paper; all authors reviewed and approved the manuscript.
Supported by the Liaoning Province Natural Science Fund Guidance Plan, No. 20180551193 (In part); and the Shenyang Science and Technology Project, No. 17-230-9-16.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chao-Liu Dai, MD, PhD, Professor, Department of Hepatobiliary and Splenic Surgery, Shengjing Hospital, China Medical University, 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. daichaoliusjh@163.com
Telephone: +86-24-9661531511 Fax: +86-24-23892312
Received: May 29, 2018
Peer-review started: May 29, 2018
First decision: July 17, 2018
Revised: September 14, 2018
Accepted: October 23, 2018
Article in press: October 22, 2018
Published online: November 26, 2018
Processing time: 181 Days and 15.9 Hours
Abstract

Liver metastasis (LM) is one of the major causes of death in patients with colorectal cancer (CRC). Approximately 60% of CRC patients develop LM during the course of their illness. About 85% of these patients have unresectable disease at the time of presentation. Surgical resection is currently the only curative treatment for patients with colorectal LM (CRLM). In recent years, with the help of modern multimodality therapy including systemic chemotherapy, radiation therapy, and surgery, the outcomes of CRLM treatment have significantly improved. This article summarizes the current status of surgical treatment of CRLM including evaluation of resectability, treatment for resectable LM, conversion therapy and liver transplantation for unresectable cases, liver resection for recurrent CRLM and elderly patients, and surgery for concomitant hepatic and extra-hepatic metastatic disease (EHMD). We believe that with the help of modern multimodality therapy, an aggressive oncosurgical approach should be implemented as it has the possibility of achieving a cure, even when EHMD is present in patients with CRLM.

Keywords: Colorectal cancer; Neoadjuvant therapy; Liver metastasis; Liver; Surgery; Liver transplantation; Hepatectomy; Laparoscopy

Core tip: Surgical resection has become the standard curative treatment for patients with resectable colorectal liver metastases (CRLM). In recent years, with the help of modern multimodality therapy, the outcomes of surgical treatment have significantly improved. The current study summarizes the current status of surgical treatment of CRLM, including evaluation of resectability, treatment for resectable liver metastases, conversion therapy and liver transplantation for unresectable cases, liver resection for recurrent CRLM and elderly patients, and surgery for concomitant hepatic and extra-hepatic metastatic disease.