, Volume 137, Issue 9, pp 1379-1396
Date: 28 Jul 2011

Chinese guidelines for the diagnosis and comprehensive treatment of hepatic metastasis of colorectal cancer

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Part one guidelines for diagnosis and treatment

The liver is the most common anatomical site for hematogenous metastases of colorectal cancer (Foster 1984; Fong et al. 1997), and hepatic metastases are one of the most difficult and challenging points in the treatment of colorectal cancer. Hepatic metastases are found among 15–25% of patients suffering from colorectal cancer at the time of primary diagnosis. Another 25–35% of patients will be found after apparently curative radical excision has been performed for the primary tumor. Most of these patients (about 80–90%) will not be suitable candidates for radical excision of their hepatic metastases. Hepatic metastases are therefore the most common cause of death for colorectal cancer patients (Foster 1984; Vibert et al. 2005; Kemeny 2006; Lau and Lai 2007; Taniai et al. 2007; Arru et al. 2008). The median survival time for patients with untreated hepatic metastases is only 6.9 months, with a 5-year survival rate of 0% (Sharma et al. 2008