Surgical treatment of colorectal liver metastases.

Recent advances not only in diagnostic imaging examinations but also in surgical techniques of liver resection have extended the indication of liver resection for colorectal metastases, and accumulated experience has improved surgical outcome. Liver metastases develop in a quarter of patients with colorectal cancer, and of these 30 % are candidates for liver resection under the criteria that liver resection is indicated when all tumors can be removed technically with adequate normal parenchyma left, no extrahepatic metastases are detectable, and the patients is considered fit for surgery. As the 5 year survival rate ranges from 30 % and 40 %, liver resection benefits 9 % to 12 % of patients with liver metastases. Recurrence in the liver remnant after liver resection develops in 40% to 50 %, and repeat liver resection benefits those patients.