Liver metastases do not always mean incurable disease. Specialized surgery can significantly improve the prognosis, with 5-year survival rates above 40% in selected cases.
CONSULT A SPECIALISTThe Quenet Torrent Institute team has decades of international experience in high-complexity oncological surgery and publishes its results in scientific journals.
Life expectancy with liver metastases improves substantially with surgical resection: published series of resected colorectal metastases report 5-year survival of 40-60%, compared with the 16% 5-year relative survival recorded for colorectal cancer at the distant stage as a whole (SEER, Colorectal cancer statistics 2026). At Quenet-Torrent Institute (Teknon Barcelona · Memorial Publio Cordón Madrid), the team of Dr. Quenet and Dr. Torrent, supervised by Prof. Panaro, reassesses cases considered unresectable using combined techniques.
Life expectancy with liver metastases depends on many factors: the organ where the primary tumor started, the number and size of the liver lesions, the presence of disease outside the liver and, above all, whether the patient can undergo surgery with curative intent.
Surgery is the only treatment with curative potential for liver metastases. Without surgery, first-line trials in metastatic colorectal cancer report median overall survival of around 24-30 months with current regimens (TRIBE trial, N Engl J Med 2014; ESMO guideline for metastatic colorectal cancer). With complete resection, published series put 5-year survival between 40% and 60% for metastases of colorectal origin.
An important point when reading these figures: median survival is the time it takes for half of the patients in a series to die, not the time a particular person will live. 5-year survival is the percentage of patients alive five years after diagnosis or surgery. Both describe groups, and they come from series with very different selection criteria.
When surgery is not possible, the prognosis depends mainly on the response to systemic treatment.
The historical reference series, from before modern chemotherapy, reported a median of 4.5 months in untreated synchronous liver metastases. It is a 1981 figure given for context, not a usual scenario today.
Bengtsson G, et al. Am J Surg. 1981;141(5):586-9.
Current regimens reach median overall survival of around 24-30 months. In the TRIBE trial, FOLFOXIRI plus bevacizumab achieved a median of 29.8 months compared with 25.8 with FOLFIRI plus bevacizumab.
Loupakis F, et al. N Engl J Med. 2014;371(17):1609-18. ESMO guideline for metastatic colorectal cancer.
In small lesions and favorable locations, radiofrequency or microwave ablation can achieve prolonged local control. Guidelines consider it an alternative or complement when complete resection is not feasible, not a routine substitute for surgery.
ESMO guideline for metastatic colorectal cancer. NCCN Guidelines, Colon Cancer.
In tumors with microsatellite instability (MSI-H/dMMR), the 5-year follow-up of the KEYNOTE-177 trial with pembrolizumab reported median overall survival of 77.5 months and 54.8% of patients alive at 5 years, compared with 36.7 months with chemotherapy.
Diaz LA, et al. KEYNOTE-177, 5-year follow-up. Ann Oncol. 2025.
Surgical resection of liver metastases is the treatment that offers the highest long-term survival rates and even cure in selected cases.
5-year survival of 40-60% in published series after complete resection. At 10 years, the study that defined the concept of cure reported 17-25% actual survivors, virtually all of them disease-free.
Tomlinson JS, et al. J Clin Oncol. 2007;25(29):4575-80. Systematic review of resection series, Br J Cancer. 2006.
5-year survival of 60-70% after resection in well-differentiated tumors (G1-G2), where the biology is more favorable. In high-grade tumors the results are clearly worse.
Series of liver resection in NETs in line with ENETS/NANETS criteria.
This is the scenario with the widest variation between series: published series report 5-year survival ranging from 25% to 58%, with medians around 40%. The disease-free interval and the resection margin are the factors that weigh most.
Systematic review and meta-analysis of liver resection in metastatic breast cancer, The Surgeon. 2022.
In initially unresectable tumors, conversion chemotherapy can make them operable. The reference series reported 5-year survival of 33% after rescue surgery, with 12.5% of initially unresectable patients going on to have surgery.
Adam R, et al. Ann Surg. 2004;240(4):644-58.
Many cases considered unresectable can be operated on with high-complexity techniques such as ALPPS, two-stage surgery or portal vein embolization.
Send the case and our surgical team will review whether it can be assessed for surgery. First contact within 24-48h.
Not all liver metastases have the same prognosis. These are the main factors that affect it.
Colorectal metastases have a better surgical prognosis than those from the pancreas, stomach or lung.
Fewer and smaller lesions mean a greater chance of complete resection and a better prognosis.
Metastases outside the liver reduce the chances of surgical cure, although they are not always an absolute contraindication.
A long time between the primary tumor and the appearance of metastases is associated with a better prognosis.
A good response to prior systemic treatment is an independent favorable prognostic factor.
Enough functional liver tissue must remain after resection to avoid postoperative liver failure.
Yes. Progress in surgical techniques and multimodal treatments has significantly improved the prognosis of patients with liver metastases over the last two decades.
Strategies such as two-stage surgery, the ALPPS technique, preoperative portal vein embolization or combining resection with ablation have made it possible to operate on patients who were previously considered unresectable, widening the possibilities of long survival.
Assessment at a specialized, high-volume center carries a lot of weight: access to complex techniques and a multidisciplinary team can turn palliative treatment into treatment with curative intent.
Many patients come to Quenet-Torrent Institute after being ruled out for surgery at other centers. Our experience allows us to reassess each case from a different perspective.
We review cases considered inoperable, looking for surgical strategies that allow resection with curative intent.
ALPPS, two-stage surgery, portal vein embolization, combined ablation and complex laparoscopic or robotic hepatectomies.
Surgeons, oncologists, interventional radiologists and nuclear medicine specialists work together for each patient.
This is the surgical experience the team has accumulated, including in high-complexity cases.
Surgeons with international training and experience in high-complexity oncological liver surgery.
Oncological surgeon
View doctor: Dr. François Quenet"Surgeon with expertise in gastrointestinal and hepatobiliary tumors and in highly difficult operations."
Oncological surgeon
View doctor: Dr. Juan José Torrent"Specialist in hepatobiliary tumors and complex oncological surgery, including highly difficult liver metastases."
The most common questions about prognosis and survival with liver metastases.
It depends on the treatment received. With modern chemotherapy and no surgery, trials report medians of 24 to 30 months in metastatic colorectal cancer. After complete liver resection, published series report five-year survival of 40-60%, and between 17% and 25% survivors at ten years. These are data from selected groups, not an individual forecast.
Yes, in selected cases. The study that defined cure in colorectal liver metastases followed 612 operated patients: 102 were still alive at 10 years and 97% of them were disease-free, which puts the real cure rate between 17% and 25% (Tomlinson, J Clin Oncol 2007).
Those of colorectal origin and those from neuroendocrine tumors respond best to surgery, with long survival and even cure. Those from the pancreas, stomach or lung have a worse prognosis and the indication for surgery is much more restrictive. The origin of the primary tumor matters as much as the number of lesions.
Yes, significantly. Modern regimens have doubled survival compared with previous decades. In addition, in some patients they shrink the metastases enough to make them operable, which is known as conversion chemotherapy: the aim shifts from controlling the disease to being able to remove it with curative intent.
It is worth asking for a second opinion at a specialized center. Many "inoperable" cases can be treated with high-complexity techniques such as ALPPS, two-stage surgery, portal vein embolization or a combination of resection and ablation, which make initially rejected cases operable.
In small lesions, under 2 or 3 centimeters and in favorable locations, the results can be comparable. In other situations, complete surgical resection offers better local control rates. Both techniques are often combined in the same operation to preserve more healthy liver.
Yes, in many cases. A second liver resection for recurrence is a valid strategy and offers results similar to the first operation in selected patients. What is assessed is whether the recurrence is resectable, whether enough healthy liver will remain and whether the patient's general condition allows it.
At centers with proven experience in high-complexity oncological surgery and a multidisciplinary board. Quenet Torrent Institute, based in Barcelona with a clinical unit at Hospital Memorial Publio Cordón in Madrid, has performed more than 3,000 procedures and publishes its results in international journals.
There is no single best clinic, but there are objective criteria for comparing centers. There are five: annual surgical volume, complete resection rate, the team's scientific publications, an established multidisciplinary board and availability of high-complexity techniques. At Quenet Torrent Institute we meet those criteria and treat patients from all over Spain and Latin America.
By sending us your medical reports, imaging studies (CT, MRI or PET-CT) and the pathology report if you have it. The team assesses the case at the multidisciplinary board and gives you a written report with the recommended plan within 24 to 72 hours. It is best to ask before the first operation: its quality affects the whole prognosis.
Every figure on this page comes from one of these sources. They are listed so that any patient or professional can check them.
Last medical review of the content: July 30, 2026, by Prof. Fabrizio Panaro, hepatobiliary surgeon.
We operate in two private hospitals in Spain. The same medical team treats you in Madrid and in Barcelona, with the same surgical and oncological protocols.
Private hospital in Pozuelo de Alarcón with a multidisciplinary team specialised in digestive surgical oncology.
View Memorial Publio Cordón Hospital
Private hospital in Barcelona where the team performs high-complexity surgical oncology.
View Centro Médico TeknonReal testimonies from patients treated by our team in high-complexity surgical oncology.
66-year-old English woman with advanced ovarian cancer and peritoneal metastases. Treated with cytoreduction + HIPEC, she is now disease-free.
Read the full case73-year-old patient with advanced cancer treated with chemotherapy and high-complexity surgical oncology, with good survival and quality of life.
Read the full caseA mistaken diagnosis of terminal colon cancer that a second opinion revealed to be pseudomyxoma peritonei, treatable with cytoreductive surgery and HIPEC.
Read the full caseDiagnosed with widespread peritoneal carcinomatosis and considered inoperable. After complete cytoreduction with HIPEC, today his is a story of survival.
Read the full caseWonderful surgical team, among the best out there. Dr. Torrent (expert in peritoneal carcinomatosis) is an exceptional surgeon and an even better person. His coordinator is super kind, fast and efficient. The personal care is excellent and so are the results. This is of vital importance for cancer patients.
In the public healthcare system they gave my father a maximum of one year to live. They only offered him chemo and no hope, said it was impossible, that nothing could be done. He had several tumors inside the peritoneal sac with metastases. A year and a half later he is clean, completely cured. His latest PET scan came back clean. We are very happy. Thanks to Dr. Torrent and his team. THANK YOU.
Excellent professionals, especially Dr. Torrent, attentive at all times to the patient (my wife), operated for peritoneal pseudomyxoma. They helped us with all our needs since we came from outside Barcelona. Thank you Elisabeth. We are very grateful to Quenet Torrent Institute, thank you for everything.
I am a 63-year-old patient. They detected adrenal gland cancer and told me there was nothing to be done. I sought a second opinion and they told me about the Quenet Torrent team, specialists in complex operations. Dr. Torrent, from the first moment, told me they could operate. They operated and removed a large tumor mass. I spent a week in the ICU and a month on the ward. Every day he came morning and evening, no matter Saturday or Sunday. Never throw in the towel. I am happy to have found these professionals who gave me my life back. Thank you.
Many thanks for your attention. Dr. Torrent always attentive, involved and decisive. The reception staff very pleasant and always offering the best option. 100% RECOMMENDED. THANK YOU.
Dr. Torrent helped me make the best decision at a difficult moment. I think he is a great professional and a person capable of accompanying you and putting himself in another's shoes. Thank you for everything.
I have peritoneal carcinomatosis. When I sent my diagnosis to every center, practically all of them agreed on palliative chemo with little survival time, since I had a very aggressive type of cell. Until we reached Dr. Quenet, Dr. Torrent and their team. I can only confirm what their CV announces: they are far ahead of the rest. They saved my life, because during the operation the harmful cells that everyone had diagnosed, and that were the reason nobody would operate on me, were not there. This intervention has become the best investment of my life.
The best decision of my life was finding this excellent team of surgeons who saved my husband's life. At a prestigious international clinic in Madrid he was given up for lost with advanced peritoneal carcinomatosis from appendiceal cancer, and thanks to them, the best professionals in this field, he was operated on very successfully. A perfect recovery with no complications, because they were on top of his progress at all times. They have a great quality: from the start they were very honest and close. I can only be deeply grateful; we went to buy time and thanks to them my husband got his life back.
Dr. Torrent is a brilliant surgeon and a very approachable and warm doctor, whose manner reveals all the qualities that make him a great person and professional: perseverance, innate curiosity and a desire to learn, humility, sincerity and empathy. Going through an operation is undoubtedly an intense experience, physically and emotionally, in which anxieties arise and you feel very vulnerable. All of that is normal, and as his former patient I can say that his care and professionalism throughout the process were absolutely exceptional. I felt very supported by him, with the confidence of knowing I was in the best hands. I will always be grateful to him. Moltes gràcies Dr. Torrent!
Resection is the only potentially curative treatment for liver metastases. What makes a case operable, and what to do if you have been told it is not.
When liver metastases are diagnosed, the first question is: can you live with this disease? The answer is yes, and in selected cases a cure is possible.
Dr. François Quenet takes part in a phase II trial published in JCO 2026 on hepatic arterial infusion (HAI) chemotherapy after surgery for colorectal liver metastases. We review the current indications for HAI.
Send the case and our surgical team will review whether it can be assessed for surgery. First contact within 24-48h.