Current diagnostic and therapeutic approaches for colorectal cancer liver metastasis.

Colorectal cancer is the second leading cause of cancer death in the developed world, due to formation of distant metastases. The liver is a primary target organ of metastatic lesions, which substantially influence the morbidity of the disease. Prompt diagnosis of colorectal liver metastases leads to early treatment, which favours a better prognosis. Consequently, the diagnostic process has shifted from traditional clinical and biochemical procedures to technologically advanced imaging modalities, such as CT, MRI, FDG-PET and PET-CT. However, the only current curative therapeutic approach is the surgical resection of metastases, using the new methods of tissue excision and haemostasis. New therapeutic modalities like cryo- or radiofrequency ablation and portal vein embolisation as well as pharmaceutical innovations such as hepatic arterial infusion chemotherapy, isolated hepatic perfusion and contemporary chemotherapeutic regimens have emerged. While still under evaluation, they present promise for the future treatment of unresectable liver metastases.