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The burden of colorectal cancer (CRC) is still increasing worldwide. Treatment of colorectal liver metastases (CRLM) is essential for long-term survival. CRLM are classified as synchronous or metachronous according to the timing of diagnosis in relation to the primary tumor. Synchronous lesions are associated with worse overall and surgical prognosis. Factors associated with poor survival in CRLM patients are age 60 years, 2 lesions, extrahepatic disease, lesion size >5 cm, positive lymph nodes near primary tumor, elevated carcinoembryonic antigen levels, absence of adjuvant treatment, resection with positive margins, and palliative treatment. Recurrence after hepatectomy is frequent; the time between liver surgery and recurrence is an important prognostic marker. To achieve the best possible long-term results, surgery with curative intent should be the rule, even with recurrent disease. Prognostic scores should be used with caution when making decisions regarding surgery but may be useful to identify candidates for chemotherapy. In this chapter, we will emphasize the outcomes and other aspects of metachronous metastases. |
