Metastectomy for combined hepatic and extrahepatic colorectal cancer metastases

Karen A. Beaty and Steven A. Curley1

(1) Department of Surgical Oncology, The University of Texas, M.D. Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 444, Houston, TX 77030, USA

Published online: 30 May 2007

Abstract The role of resection of hepatic colorectal cancer metastases is generally accepted. The presence of extrahepatic metastatic disease came to be considered an absolute contraindication to resection of hepatic colorectal cancer metastases in the late 1980s and early 1990s. This dogmatic surgical view developed at a time when there were few active systemic chemotherapeutic options available to treat patients with stage IV colorectal cancer. Recent studies have indicated that complete surgical resection of all hepatic and extrahepatic metastatic disease can yield 5-year overall survival rates in excess of 30% in carefully selected patients. Response to chemotherapy may be an important prognostic indicator in patients with combined hepatic and extrahepatic metastatic disease. The presence of extrahepatic disease should no longer be considered an absolute contraindication to surgical treatment, and multidisciplinary treatment planning should be considered in all patients with potentially resectable hepatic and extrahepatic colorectal cancer metastases.