Induction chemotherapy and surgery of colorectal liver metastases

Surgery is the only curative treatment for patients with colorectal liver metastases with recent reports documenting 5-year survival results of 40-50 %. In unresectable patients, the use of more effective regimens of chemotherapy has contributed to improve the results of survival at short term and new onto-surgical strategies have emerged. By allowing resection of previously unresectable liver metastases, these onto-surgical strategies now offer 15-20 % of patients a real potential of long-term remission (5-year survival 30-40 %). Chemotherapy is also used in the adjuvant setting; to prevent post-operative recurrence. In resectable metastases, it may also be used as neo-adjuvant treatment to control tumor progression before surgery and to select the patients likely to really benefit from liver resection. The objective of this article is to describe this multidisciplinary approach of liver metastases and to report the results of these crew strategies.