Advances in understanding of colorectal liver metastasis and implications for the clinic

Abstract

Colorectal cancer is one of the most common cancers in both the USA and Europe. Over the course of diagnosis, treatment and surveillance, up to 50% of these patients will develop metastases to their liver. In the past 20 years alone, there have been multiple advances in the management of these colorectal metastases to the liver. These advances have been made in characterization of these tumors, diagnosis and in treatment, both locally and systemically. Because of this progress, there are subsets of patients with this stage IV disease who are cured of their disease. While significant progress has been made, there still exist limitations in the management of metastatic colorectal cancer to the liver. This review outlines current strategies and highlights recent advances in the management of colorectal liver metastases.

Keywords:

• ablation
• colorectal liver metastases
• disappearing liver metastases
• outcomes

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Up to 50% of patients diagnosed with colorectal cancer will develop liver metastases; these metastases may present synchronously or metachronously.

• The molecular signatures of colorectal metastases and their corresponding primary tumors represent a growing field and are guiding local and systemic therapeutic options.

• Surgical resection with a microscopically negative margin offers the best therapy for cure in patients with colorectal liver metastases.

• Local therapies such as radiofrequency ablation, stereotactic body radiation therapy, transarterial chemoembolization with drug-eluting beads with irinotecan, transarterial radioembolization with Y-90 and hepatic artery infusion pumps have shown promise in the management of unresectable colorectal liver metastases, but their precise clinical application has not yet been defined.

Notes