Interdisciplinary management of colorectal liver metastases

Background: Liver metastases occur in every second patient with colorectal carcinoma. Objectives: Therapeutic options for patients with hepatic metastases from colorectal cancer (CRC), specific indications, and interdisciplinary concepts are presented. Methods: Based on the current literature and guidelines, novel study results and expert opinions are discussed. Results: Surgical resection of primarily resectable liver metastases from CRC is standard and allows long-term control or healing in up to 36 % of cases. Adjuvant chemotherapy after resection can be performed, but the current study data are insufficient to generally recommend perioperative chemotherapy in this setting. Secondary resectability of primarily irresectable metastases can be reached by interventional induction of liver hypertrophy or neoadjuvant chemotherapy (conversion therapy). New study results suggested a benefit for more intensive combination chemotherapies, but possible side effects have to be considered. Finally, locoregional ablative therapies have gained increasing importance in the multimodal treatment of hepatic CRC metastases, and current clinical trials suggest a possible benefit of combination strategies together with chemotherapy and surgery even in early therapy lines. Conclusions: Liver metastases from CRC require an multidisciplinary approach. Therefore, patients should be presented to a multidisciplinary tumor board not only at the beginning, but also along different therapy lines. © 2016, The Author(s).