Extending the frontiers of resectability in advanced colorectal cancer.

AIM

To review the advances in the past decade that have enabled more patients with colorectal liver metastases (CRLM) to undergo curative hepatic resection.

METHODS

A comprehensive literature review and pertinent data published on advanced CRLM from The University of Texas M. D. Anderson Cancer Center were used for this review.

RESULTS

Criteria for resectability of CRLM have expanded with the advent of effective chemotherapy, improved surgical technique, and novel strategies such as preoperative volumetry, portal vein embolization, and two-stage hepatectomy. Despite the aggressiveness of these approaches to treating patients with advanced disease, recent series show an improvement in 5-year survival rate for patients with CRLM.

CONCLUSIONS

Advances in multidisciplinary management and careful patient selection have enabled more patients to undergo curative resection for CRLM, with corresponding improvement in survival rates.