Hepatic resection is the only treatment that currently offers a chance of long term survival in patients with colorectal liver metastases and is associated with 5 years survival rates ranging from 25 to 39%.
The standard treatment of synchronous colorectal liver metastases is removal of primany tumour followed by 3-6 courses of chemotherapy and then if metastases are resectable, this will be followed by liver surgery. However only few patients can benefit from this strategy, mostly because the metastases are considered unresectable from the begining or because they progrese during treatment of primary tumour.
Over the last decade major advances in chemotherapeutic agents substantially improved the chances of cure of patients . With stage IV colorectal cancer , while the traditional treatment using 5-FU and leucovorin had low response rates ( |