Current Trends in the Surgical Management of Colorectal Cancer Liver Metastases

Purpose of Review: Cancers of colorectal origin are the second leading cause of cancer-related deaths in the USA, and with the improvements in chemotherapy and other therapeutic modalities, there are more options for the management of metastatic disease. The liver is the most common site of colorectal metastasis, and treating the disease to the liver may lead to prolonged survival and possible cure. Our understanding of tumor biology and the refinement of surgical techniques have resulted in significantly improved outcomes. The treatment of colorectal liver metastasis is complex and thus requires a multidisciplinary approach. Recent Findings: There is increasing body of literature that points towards more aggressively selective and personalized surgical treatment of colorectal cancer liver metastases. New techniques like hepatic artery infusion, liver chemoperfusion, operative and transcutaneous liver ablation with microwave, radiofrequency or irreversible electroporation have resulted in significantly improved outcomes. Summary: There is significant progress in the surgical management of liver metastasis of colorectal origin, with improved outcomes in patients that otherwise would be candidates only for palliative chemotherapy. More and exciting research is underway in order to appreciate the impact of newer techniques.