research article

Surgical management of liver metastases from colorectal cancer

Abstract

With the persistent rise in colorectal cancer incidence,approximately 50% of patients develop liver metastases during the disease course. According to international staging systems,colorectal cancer liver metastases(CRLM)are classified as advanced-stage malignancies,typically associated with poor clinical prognoses.In recent years,the CRLM treatment paradigm has undergone multidimensional evolution. Against the backdrop of continuously evolving therapeutic concepts,comprehensive treatment strategies centered on surgical intervention have demonstrated substantial survival benefits. Notably,the integration of novel therapies-including targeted agents and immunotherapy-has not only significantly extended overall survival in advanced cases but also markedly improved the resectability of hepatic metastatic lesions. From a technical perspective,innovations such as intraoperative ultrasound navigation,radiofrequency ablation combined with resection techniques,and fluorescence laparoscopy-guided precise hepatectomy have achieved breakthroughs in surgical safety and accuracy. Nevertheless,critical controversies persist in the surgical management of CRLM,particularly regarding the refinement of surgical indications,optimization of surgical timing within multidisciplinary frameworks,and evidence-based selection of local treatment modalities,all of which remain subjects of ongoing debate.This review synthesizes recent high-impact literature with our institutional expertise in CRLM management to summarize contemporary advancements and share practical insights,aiming to inform clinical decision-making and enhance surgical outcomes in CRLM treatment

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