Hepatic colorectal metastases: methods of improving resectability

Eighty to ninety percent of patients with colorectal liver metastases present with surgically unresectable lesions at time of diagnosis. However, complete surgical resection is the only treatment that results in long-term survival. Improving efficacy of chemotherapy in metastatic colorectal cancer during the last decade has been a major drawback in-achieving the objective of resectability. Specific surgical techniques such as portal venous embolization, local destructive therapies, two-stage hepatectomies, and different types of vascular control during parenchymal dissection have further expanded the classical limits of unresectability. This article describes the authors' experience and results with the application of different methods used to improve the resectability of hepatic colorectal metastasis.