Evolving techniques in the treatment of liver colorectal metastases: Role of laparoscopy, radiofrequency ablation, microwave coagulation, hepatic arterial chemotherapy, indications and contraindications for resection, role of transplantation, and timing of chemotherapy

Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Patients who have untreated liver metastases from CRC rarely survive 5 years and have a reported median survival of 6 to 13 months. The 5-year overall survival following resection of CRC liver metastases in current series is up to 58%. Unfortunately, most patients are not candidates for resection because of the extent or distribution of disease. Consequently, several alternate methods are being used to treat hepatic metastases from CRC, including microwave coagulation, radiofrequency ablation, and transplantation. This article provides a summary of the major studies that have been performed examining the modalities used in the management of hepatic metastases.