ABSTRACT
Currently hepatic resection is established as the treatment modality of choice for colorectal liver metastases (CRLM) with 5-year survival rates of up to 60% being reported by some groups ( 3-6 ). Unfortunately at the time of presentation only 20% to 30% are deemed suitable to resection because of tumor location, number of metastases, other comorbidities, and lack of hepatic reserve ( 7 ). Consequently, in recent times there has been considerable interest in the use of oxaliplatin-based neoadjuvant therapy to reduce tumor burden, so increasing the probability of achieving a curative resection and hence improve overall disease-free survival. Even patients who initially had unresectable hepatic disease may respond to chemotherapy and become resectable ( 8 ). However, despite a more aggressive approach to surgical resection and the use of combination regimens of highly active chemotherapy drugs, a significant proportion of patients are still not eligible for resection. Additionally, the high rate of recurrence seen in the liver, affecting 53% to 68% of patients requiring repeat resections can only be tolerated by a subset of patients ( 9 ).
