BACKGROUND: Recent advances have extended indications for hepatectomy to include @entity14 (CLM). Staging systems based on the biological malignancy of primary and @entity3 provide appropriate indications for hepatectomy in CLM. However, suitability for resection in @entity1 with @entity99 is controversial. METHODS: A medline search was performed to identify papers reporting the resection for CLM. Techniques, indication, and results were reviewed. RESULTS: If the anticipated remnant liver volume is small (25-40% of total), suggesting a high risk of @entity1578 , portal vein embolization (PVE) is recommended prior to hepatectomy. However, curative resections are not always possible. Specifically in synchronous multiple bilobar CLM, two-stage hepatectomy, comprising bilateral hepatectomy and primary resection with or without PVE, can prevent growth of ipsilateral metastatic nodules in the remnant liver and reduce surgical risk. Several local ablation techniques can complement surgery if hepatic resection alone increases the risk of @entity1578 or is not curative. Chemotherapy combined with targeted treatment can suppress recurrence and extend indications for hepatectomy by reducing the size and number of primary irresectable @entity5 . CONCLUSION: PVE or staged procedure combining with local ablation or neoadjuvant, downstaging or adjuvant therapies extends indications for hepatectomy to include multiple bilobar CLM. The 5-year survival rate for multiple bilobar CLM treated with alternating hepatectomy and chemotherapy is comparable to the values reported for single and hemilateral CLM.

Treatment for multiple bilobar liver metastases of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumors'] @entity1578 :: ('MESH:D017093', 'Disease') :: ['postoperative liver failure'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastatic tumors'] @entity14 :: ('MESH:D015179', 'Disease') :: ['multiple bilobar colorectal liver metastases'] @entity99 :: ('MESH:D056486', 'Disease') :: ['complex and extensive hepatic metastases']
@entity14 :: (MESH:D015179,Disease) :: ['colorectal cancer']
