Liver Metastases

Liver metastases, often from colorectal cancer, present a complex challenge in oncology. Successful management hinges on careful assessment of resectability, which entails complete tumor removal while preserving adequate liver function. Preoperative evaluation is crucial, with MRI and triphasic CT scans being preferred for their sensitivity in detecting liver lesions. PET scans play a pivotal role in identifying any extrahepatic disease. Surgical resection is the cornerstone of treatment for resectable colorectal liver metastases (CRLMs), aiming for negative margins to ensure the best outcomes. In cases of extensive bilobar disease, a two-stage hepatectomy might be considered, involving initial resection and subsequent surgery after liver regeneration. For patients with unresectable metastases, locoregional therapies such as radiofrequency ablation (RFA) and stereotactic body radiotherapy (SBRT) offer alternative treatment options. Liver transplantation remains a controversial and limited option, reserved for highly selected patients with metastatic colorectal cancer confined to the liver. Overall, a multidisciplinary approach involving surgeons, oncologists, and radiologists is essential for optimal management of liver metastases.