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.