Debate: Improvements in Systemic Therapies for Liver Metastases Will Increase the Role of Locoregional Treatments

Abstract

The benefit of resection of liver metastases depends on primary diseases. Neuroendocrine tumors are associated with favorable prognosis after resection of liver metastases. Gastric cancer has worse tumor biology, and resection of gastric liver metastases should be performed in selected patients. A multidisciplinary approach is well established for colorectal liver metastases (CLMs). Resection remains the only curative treatment of CLM. Chemotherapy and molecular-targeted therapy have improved survival in unresectable metastatic colorectal cancer. Understanding of the following two strategies, conversion therapy and two-stage hepatectomy, are important to make this patient group to be candidates for curative-intent surgery.

Keywords: Chemotherapy; Colorectal liver metastasis; Conversion therapy; Gastric liver metastasis; Molecular-targeted therapy; Neuroendocrine liver metastasis; Resection; Two-stage hepatectomy.