Treatment of liver metastases

Background The liver is the main destination for distant metastases of gastrointestinal as well as other malignancies. Consequently, the therapy of liver metastases plays a key role in oncological treatment strategies.Objectives In this review, the current treatment options and multimodal therapy strategies for liver metastases are presented.Materials and methods Current literature and national/international consensus guidelines are reviewed and general treatment options for liver metastases are summarized and then presented for the respective malignancies.Results According to treatment strategy and prognosis, liver metastases are divided into three categories: colorectal liver metastases (CRLM), neuroendocrine liver metastases, and non-colorectal non-neuroendocrine liver metastases which include liver metastases of all other malignancies. Due to their highest incidence, CRLM are of major interest. The individual treatment is chosen according to patient's oncological situation, liver function, and comorbidities.Conclusions Surgery is the best curative treatment option. Thus, all patients should be evaluated for surgery in specialized oncological boards. Despite higher local recurrence, local ablation methods are good alternative options for small and limited metastases. Systemic treatments and radiation are implemented in palliative settings as well as multimodal treatment strategies with the goal of cure.