Evidence for resection of colorectal liver metastases

Historically, hepatic resection has provided superior treatment outcomes for patients with liver metastases from colorectal cancer, with 5-year survivals consistently reported between 30% and 40%. Over the past decade a number of therapeutic modalities have emerged, including novel systemic chemotherapy regimens and novel ablation techniques. Even with expansion of the indications for hepatic resection, hepatic resection has become safer and more effective over the same time period. Review of the current literature finds several reports documenting that 5-year overall survivals for resected patients with colorectal liver metastases have now improved to 58%. In addition, recent studies comparing recurrence and survival rates in patients treated with hepatic resection and radiofrequency ablation indicate that hepatic resection continues to provide superior outcomes. Combined, these reports confirm that hepatic resection remains the gold standard for the treatment of patients with colorectal liver metastases and emphasizes the importance of surgical evaluation for all patients with potentially resectable disease.