Conversion Chemotherapy for Unresectable Colorectal Liver Metastases: Are We Making a Difference?

Surgical resection remains the only curative therapy for colorectal liver metastases (CLM) with 5-year survival rates ranging from 40 to 58 %. Unfortunately, only approximately 15–25 % of patients are eligible for initial surgical resection. Among those that are unresectable, response to chemotherapy can convert an additional 15–20 % of unresectable patients to a potentially resectable state and offer curative-intent resection. In this select group of patients undergoing resection following conversion chemotherapy, 5-year survival rates approach 50 %. Despite a slightly shorter time to recurrence post-hepatectomy following conversion chemotherapy, these select patients have a significant survival advantage compared to palliative chemotherapy alone.