A 55-year-old man is found to have a 3 cm solitary hepatic metastasis from colorectal cancer, confirmed on PET-CT with no other distant disease. His primary tumour has been resected with clear margins. What is the most appropriate management of the liver metastasis?
- A Palliative FOLFOX chemotherapy only
- B Liver resection with curative intent achieves 5-year survival of 25–40% ✓
- C Radiofrequency ablation is superior to surgical resection in all cases
- D Liver transplantation after neoadjuvant chemotherapy
Correct answer: B. Liver resection with curative intent achieves 5-year survival of 25–40%
Explanation
Solitary colorectal liver metastasis in a patient with resectable primary is a potentially curable situation. Liver resection with curative intent offers a 5-year survival of 25–40%, significantly better than palliative chemotherapy alone (<5%). Resectability criteria include adequate future liver remnant (≥20–30%), clear margins, no extrahepatic disease, and fitness for surgery. RFA is an adjunct for small, inaccessible lesions, not universally superior. Liver transplantation is not standard for CRC metastases.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.