Surgical treatment of liver metastases from colorectal carcinoma

In patients with colorectal liver metastases, hepatic resection is the treatment of choice, and the 5-year overall survival rate after surgery is now approaching 60%. The multidisciplinary and multimodality approaches that may include preoperative systemic chemotherapy, and the recent innovative surgical techniques that may include complex ultrasound guided hepatic resection, have enabled a large proportion of patients to undergo potentially curative treatment. The definition of resectability has shifted from a focus on tumor characteristics, such as tumor number and size, to determination whether both intrahepatic and extra-hepatic disease can be completely resected, and whether such an approach is appropriate from an oncological standpoint. Hepatobiliary surgeons and medical oncologists should work together to evaluate patients with colorectal liver metastases to individualize the treatment strategy to maximize the chances of long-term survival.