**5. Rescuing more patients**

In 1986, Ekberg provided several contraindications for the surgery of liver metastases of colorectal origin (4 or more nodules, a size greater than 5 cm, presence of extrahepatic disease and the inability to resect with a margin greater than 1 cm). Others studies corroborated these findings. A thorough analysis of these papers could have reduced their influence realising that they had short series or that their statistical analysis was univariate. As previously stated, these criteria are deemed obsolete. So the question is: can all disease be resected while leaving a functional liver remnant? (Charnsangavej et al. 2006). There exist some innovative strategies that increase the volume of the hepatic remnant. Portal vein embolization (PVE) or ligation causes atrophy of the ipsilateral hemiliver and hypertrophy of the contralateral side. PVE appears to be particularly valuable in patients who present with underlying liver disease. The concomitant administration of chemotherapy may decrease both the tumour load and post-operative recurrences. Furthermore, aggressive approaches in selected cases can provide the only possible cure.
