Chemotherapy-Associated Hepatotoxicity and Hepatic Resection for Metastatic Colorectal Cancer

Approximately 50 % of patients with colorectal cancer will develop liver metastases. Complete resection is associated with 50 % five-year overall survival and 20 % long-termcure. Use of preoperative chemotherapy for patients with resectable colorectal metastasis to the liver is controversial. Among the arguments against use of preoperative chemotherapy is the resulting hepatotoxicity, which may increase the risk of hepatectomy. In this review, we assess the liver-specific toxicity profiles of the most commonly used chemotherapy agents and how this toxicity affects perioperative outcomes. We also comment on the use of neoadjuvant chemotherapy for patients with resectable colorectal metastasis.