Surgery of liver metastases from colorectal cancer: new promises.

For a long time, patients with liver metastases from colorectal cancer were considered to be incurable. Over the last 30 years, the benefits of surgical resection and systemic chemotherapy have been established. Actually, surgical resections are feasible with a very low mortality and a 5-year survival that approaches 40%, but only 10-20% of patients are candidates for surgery. The others gain benefit from chemotherapy with increasingly active drugs. To improve this overall picture, efforts have been made to increase the number of patients that could be candidates for surgery and to decrease the risk of recurrence after surgical resection. Shrinkage of tumours after administration of pre-operative chemotherapy and the availability of ablative techniques now allow the treatment, with curative intent, of metastases initially considered as non-resectable. Chemotherapeutic regimens have been developed to decrease the risk of postoperative recurrence.