简介:Livermetastasessynchronouslyormetachronouslyoccurinapproximately50%ofcolorectalcancerpatients.Multimodalitycomprehensivetreatmentisthebesttherapeuticstrategyforthesepatients.However,theoptimalpatternofmultimodalitytherapyisstillcontroversial,anditraisesseveralsignificantconcerns.Liverresectionisthemostimportanttreatmentforcolorectallivermetastases.ThedefinitionofresectabilityhasshiftedtofocusonthecompletionofR0resectionandnormalliverfunctionmaintenance.Theroleofneoadjuvantandadjuvantchemotherapystillneedstobeclarified.Themanagementofeitherprogressionorcompleteremissionduringneoadjuvantchemotherapyischallenging.Theoptimalsequencingofsurgeryandchemotherapyinsynchronouscolorectallivermetastasespatientsisstillunclear.Conversionalchemotherapy,portalveinembolization,two-stageresection,andtumorablationareeffectiveapproachestoimproveresectabilityforinitiallyunresectablepatients.Severaltechnicalissuesandconcernsrelatedtothesemethodsneedtobefurtherexplored.Forpatientswithdefinitelyunresectableliverdisease,thenecessityofresectingtheprimarytumorisstilldebatable,andevaluatingandpredictingtheefficacyoftargetedtherapydeservefurtherinvestigation.Thisreviewdiscussesdifferentpatternsandimportantconcernsofmultidisciplinarytreatmentofcolorectallivermetastases.