Modern Management of Hepatic Metastatic Disease

Colorectal cancer is the third leading cause of cancer deaths in both men and women with 136,830 new cases in the United States estimated to be diagnosed in 2014 [1]. For individuals diagnosed with colorectal cancer, approximately 20% of patients will have metastatic disease at the time of initial diagnosis [2]. Despite the overall incidence of colorectal cancer declining, the number of patients presenting with metastases has remained relatively unchanged. In multiple population-based studies, the incidence of synchronous liver metastases was reported to be 14–18% [3–5]. Similarly, on a population level, the rate of metachronous liver metastases was approximately 12–14% at 3 years [3, 4]. The liver is the most common site of distant colorectal metastases and disease is limited to this site in at least one-third of the patients [6]. Overall, approximately 50% of patients will develop liver metastases at some point during the course of their disease.