Surgical and Ablative Modalities for the Treatment of Colorectal Cancer Metastatic to the Liver

Colorectal cancer is the second leading cause of mortality from cancer in the United States. Death from colorectal cancer usually results from metastatic disease to the liver. Complete surgical resection is the only potentially curative treatment option for metastatic colorectal cancer to the liver, with a five-year survival rate of approximately 30%-40%. The addition of adjuvant systemic or hepatic intra-arterial pump chemotherapy appears to improve survival. Treatment options for unresectable disease in the liver are cryosurgery (intraoperative freezing of tumors), radiofrequency ablation (intraoperative or percutaneous heating of tumors), hepatic intra-arterial infusion pump chemotherapy (regional chemotherapy), and systemic chemotherapy. This article describes metastatic colorectal cancer disease presentation, extent of disease evaluation, and nonchemotherapeutic treatment options, including surgical and ablative therapies. The nurse's role in caring for this population also will be discussed.