Abstract

Colorectal cancer is the third commonest malignancy worldwide and the second commonest cause of cancer-related deaths.1,2 Around 15–25% of patients with colorectal cancer have metastases at presentation, and a further 20–25% develop them subsequently.3 Management for metastatic disease is mainly palliative and traditionally 5-year survival has been rare.3–5 In colorectal cancer, metastases mostly occur in the liver and in 30–50% of patients with liver involvement, this is the only site of spread. For those with liver-only metastases, resection of these lesions provides a chance of longer-term survival or even cure (e.g. 5-year survival 25–71%).4,6–13 Here we focus on recent advances in chemotherapy for patients with initially unresectable liver metastases, aimed at rendering such lesions operable, with potential improvements in survival.4,13,14