Current Surgical Therapy of Hepatic Colorectal Metastasis Aktuelle Chirurgie kolorektaler Lebermetastasen

Summary: Background: Liver resection represents the only cure for patients with hepatic metastases from colorectal cancers.Methods: The discussion will address which patients should be considered for hepatic resection, what are the appropriate diagnostic modalities to employ, and what are the hallmarks of surgical therapy. The biologic determinants of recurrence as the basis for rational patient selection for hepatectomy will be addressed. This review will then concentrate on recent data guiding adjuvant therapy, and emerging developments for staging.Results: Median survival of patients after liver resection for hepatic metastases is on the order of 40 months (45, 93, 105), five-year survival is 30 % – 40 %, and ten-year survival approximately 20 %. Operative mortality at most major centers is uniformly less than 5 %.Conclusions: These comparative results have made any random-assignment trial of resection versus nonresectional approach unethical and resection the standard of care.