Almost half of patients with colorectal cancer develop metastases many of which are located in the liver, and a quarter of which may be amendable to surgery. If all disease is removed these patients have a 30% to 50% chance of survival at five years.
Treatment options include surgical removal of the diseased section of the liver as well as other modalities such as cryosurgery and radiofrequency thermal ablation. Although new treatments allow safe destruction of liver metastases, often without the need for major surgery, there are still no clear guidelines on the appropriate management of patients with colorectal cancer liver metastases. Only one low quality study which reported improved disease-free survival in patients who underwent cryosurgery compared with conventional techniques, was included in this review.
There is very limited evidence to support the effectiveness or otherwise of a single approach, either surgical resection or other surgical procedure for the management of colorectal liver metastases. Further research is required to evaluate the effects of these treatment options and their role in increasing disease-free survival and in decreasing recurrence. Treatment decisions should continue to be based on individual circumstances and clinician's experience.