Laparoscopic Management of Colorectal Liver Metastases
Colorectal cancer is the third most common cancer worldwide, with a lifetime risk of approximately 5 %. The most common site for haematogenous metastasis is the liver. Approximately 10–20 % of patients with colorectal adenocarcinoma will have synchronous hepatic metastasis at the time of diagnosis, and 20–25 % of the patients will develop metachronous metastasis later in life. Without treatment, the prognosis of colorectal cancer with liver metastasis is poor, and the 5-year survival rate is less than 5 %. At present, liver resection offers the best chance of survival for patients with colorectal cancer liver metastasis. Currently the 5-year survival rate following curative resection of colorectal liver metastasis approaches 45–60 %. Many reasons have contributed to the better results of colorectal liver metastasis. Improved patient selection in a multidisciplinary team setting, increased understanding of liver surgery and anaesthesia, technological improvements, advances made in diagnostic and interventional radiology and advances made in the field of chemotherapy are to name a few contributory factors.