Non-resection approaches for colorectal liver metastases

Surgical resection has become a widely accepted method for achieving long-term survival and even cure in selected patients with hepatic colorectal metastases. Only a minority of patients with liver metastasis are considered to be candidates for resection, however, and the remaining patients with unresectable disease commonly are offered palliative systemic chemotherapy that improves quality of life but has little impact on survival. There has been considerable expansion in the use of tumor ablative techniques alone or in conjunction with resection and they represent viable palliative options, primarily because of the associated low morbidity and mortality. Before these techniques can be considered standard independent therapies, it is imperative that well-designed clinical trials are conducted to validate single institutional results.