n CME : Your SA Journal of CPD - Modern management of colorectal liver metastases




Colorectal cancer is one of the commonest malignancies worldwide. The liver is the most frequent site of metastasis from colorectal cancer and overall close to 50% of patients will develop liver metastases during the course of the disease. In one-third of patients, the liver metastases are synchronous, i.e. present at the time of diagnosis, while in two-thirds metastases are metachronous, presenting later. Surgical resection is the only established curative treatment in patients with colorectal liver metastasis. The rationale for resection is based on the recognition that colorectal tumour cells initially spread haematogenously via the portal circulation, making the liver the first site of metastasis in most patients. Liver resection has been shown to extend survival; without surgical resection, 5-year survival is rare and median survival is less than 12 months. Five-year survival after liver resection and chemotherapy now exceeds 40%.


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