Modern oncosurgical treatment strategies for synchronous liver metastases from colorectal cancer

Optimal management of synchronous colorectal liver metastases demands a well-organized inter-disciplinary strategy by surgeon, oncologist and radiologist. Over the past decade, advances in management strategies of patient with liver-limited metastases have incredibly improved the overall prognosis. This review discusses the advances made in the management of patients with colorectal cancer liver metastases.A literature search was performed, using the following databases: PubMed, SCOPUS sciencedirect, EMBASE, and NHS Knowledge Network. The retrieved articles were assessed for relevance for inclusion in this review. The review illustrates that although currently surgery offers the best chance of cure in patients with colorectal liver metastases, the majority of patients are not initially resectable due to the size, anatomic location, extent of disease, inadequate remnant liver volume, or comorbidities. This necessitates other treatment modalities to control or downsize the hepatic lesions before embarking on the surgical intervention. Systemic and regional chemotherapy complements the surgical cure in the majority of patients.