Personalizing Locoregional Therapy for Patients with Metastatic Colorectal Cancer

Purpose of review: The management of metastatic colorectal liver disease has improved overall survival by multidisciplinary approach utilizing systemic treatment followed by local control of metastatic disease. There has been an evolution of local control therapy which has expanded the new armamentarium for treatment of resectable and unresectable liver disease. The review article will address the various types of locoregional therapy and various indications for its use. Recent findings: The application of ablative therapies combined with resections has allowed single-stage resection for patients with bilobar disease with excellent safety and efficacy. In patients with unresectable colorectal metastasis to the liver, chemo- and radio-embolization have provided improved survival outcome compared to systemic chemotherapy alone. Summary: Locoregional therapy for metastatic colorectal liver disease can improve outcome as an adjunctive role in combination with resection or as a sole therapy for patients with unresectable disease.