How Does One Select Patients With Colorectal Cancer Of The Liver Who Will Benefit From Surgical Resection

The criteria for the selection of patients have evolved in last two decades. Ekberg et al. (20) proposed three general contraindications to liver resection for metastatic colorectal cancer (CRC) in their landmark article in 1986—the presence of four or more lesions, presence of additional extrahepatic disease, and resection margin of <1 cm. In recent decades, as safety of hepatectomy has improved and long-term follow-up data have matured, surgeons have adopted a more aggressive approach toward liver resection (21-24).

In general, patients are offered resection if (i) they are deemed candidates for major surgery from a medical standpoint; (ii) there is no extrahepatic disease; and (iii) adequate residual liver will remain after resection to allow complete recovery. The contraindications to liver resections are listed in Table 1.

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