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J.Jpn. Surg. Soc.. 122(2): 153-159, 2021

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Department of Gastroenterological Surgery, Kumamoto University Graduate School of Life Science, Kumamoto, Japan

Yuki Kitano, Katsunori Imai, Hiromitsu Hayashi, Yo-ichi Yamashita, Hideo Baba

Surgical resection for colorectal liver metastases (CRLM) is the only treatment that can improve patient prognosis. However, only about 20% of CRLM cases are indicated for resection at the time of diagnosis (initially resectable), and the remainder are treated as unresectable cases (initially unresectable). Thanks to remarkable developments in chemotherapy, interventional radiology, and surgical techniques in recent years, the resectability of CRLM is expanding. However, some cases are technically resectable, but physicians are oncologically hesitant to perform upfront surgery. In pancreatic cancer, such cases are defined as borderline resectable, and their anatomic features and treatment strategies have been clarified. However, in CRLM, although various poor prognostic factors have been reported, a clear definition and treatment strategy for borderline resectable cases have not yet been presented. Since the efficacy of hepatectomy for CRLM was reported in the 1970s, it has been believed that multidisciplinary treatment for unresectable cases improves resectability and prognosis. Moreover, clarifying the definition and treatment strategy of borderline resectable CRLM may improve patient prognosis. This review outlines the present status of and future perspectives on borderline resectable CRLM based on previous reports.

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