Fédération des spécialités digestives, hôpital Ambroise Paré, 9, avenue Charles-de-Gaulle 92104 Boulogne Cedex.
Over the last 30 years, the benefits of surgical resection and systemic chemotherapy in the management of hepatic metastases from colorectal cancer have been established. Actually, surgical resections are feasible with a very low mortality and a 5-year survival that approaches 50 %, but only 10 % to 20 % of patients are candidate to surgery. The others gain benefit from chemotherapy with more and more active drugs. To improve this overall picture, efforts have been made to increase the number of patients that could be candidates for surgery and to decrease the risk of recurrence after surgical resection. Shrinkage of tumours after administration of preoperative chemotherapy and availability of ablative techniques (radiofrequency and cryotherapy) now permit to treat with curative intent metastases initially considered as non resectable. Chemotherapeutic regimens to decrease the risk of postoperative recurrence are actually tested in clinical trials.