Guideline for diagnosis and comprehensive treatment of colorectal liver metastases (Version 2025)

doi:10.3877/cma.j.issn.2095-3224.2025.05.004

Abstract

Abstract:

The liver is the main target organ for hematogenous metastases of colorectal cancer, and colorectal liver metastasis is one of the most difficult and challenging situations in the treatment of colorectal cancer. In order to improve the diagnosis and comprehensive treatment in China, the guidelines have been edited and revised for seven times since 2008, including the overall evaluation, personalized treatment goals and comprehensive treatments, to prevent the occurrence of liver metastases, increase the local damage rate of liver metastases, prolong long-term survival, and improve quality of life. The revised guideline version 2025 includes the diagnosis and follow-up, prevention, multidisciplinary team, surgery and local ablative treatment, neoadjuvant and adjuvant therapy, and comprehensive treatment. The revised guideline emphasizes precision treatment based on genetic molecular typing, especially recommending immune checkpoint inhibitors for mismatch repair defects/microsatellite instability-high(dMMR/MSI-H) patients, and enriched local treatment methods, such as liver transplantation, yttrium-90 microsphere selective internal radiotherapy, etc. The revised guideline includes state-of-the-art experience and findings, detailed content, and strong operability.

Key words: Colorectal cancer, Liver metastases, Diagnosis, Comprehensive treatment, Guideline

Chinese College of Surgeons, Section of Gastrointestinal Surgery, Branch of Surgery, Chinese Medical Association, Section of Colorectal Surgery, Branch of Surgery, Chinese Medical Association, Colorectal Cancer Professional Committee, Chinese Anti-Cancer Association, Colorectal Cancer Professional Committee of the Chinese Medical Doctor Association, Colorectal Cancer Expert Committee, Chinese Society of Clinical Oncology, Chinese Society of Colon & Rectal Surgeons, Chinese College of Surgeons, Chinese Medical Doctor Association, Metastasis Research Committee, Anorectal Branch of Chinese Medical Doctor Association, Section of Colorectal Oncology, Oncology Branch, Chinese Medical Association, Branch of Metastatic Tumor Therapy, China International Exchange and Promotive Association for Medical and Health Care, Branch of Colorectal Disease, China International Exchange and Promotive Association for Medical and Health Care. Guideline for diagnosis and comprehensive treatment of colorectal liver metastases (Version 2025)[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2025, 14(05): 398-411.

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References 240

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