Liver metastases from colorectal cancer : a multidisciplinary approach is necessary

A multidisciplinary approach is necessary to determine the adequatetreatment of patients with liver metastases from colorectal cancer.The benefits of surgical resection and systemic chemotherapy havebeen established. To date, surgical resection remains the only treat -ment that can ensure long-term survival and cure in some patients.However, only a minority of patients with liver metastases are amenableto surgery and after resection of liver metastases, recurrencesare still observed in two thirds of patients. Therefore, efforts havebeen made to increase the number of patients that could be candidatesfor surgery and to decrease the risk of recurrence after surgicalresection. Shrinkage of tumours after administration of preoperativechemotherapy and the availability of new surgical techniques,including portal vein embolization, cryotherapy and radiofrequencyablation, now allow the treatment, with curative intent, ofmetastases initially considered as non-resectable. Chemotherapyregimens have been developed to decrease the risk of postoperativerecurrence.