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Liver-directed therapies for gastrointestinal malignancies
1Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Current Opinion in Oncology
|July 1, 1997
Summary
For liver cancer patients ineligible for surgery, alternative hepatic-directed therapies offer survival benefits. These include chemotherapy infusions and hepatic artery infusion, with other methods needing further evaluation.
Area of Science:
- Hepatobiliary Malignancies
- Surgical Oncology
- Interventional Radiology
Background:
- Surgery is the primary treatment for primary and secondary liver cancer.
- Many patients with hepatic tumors are not candidates for surgical resection.
- Alternative hepatic-directed therapies are crucial for non-resectable cases.
Purpose of the Study:
- To review non-surgical hepatic-directed therapies for liver malignancies.
- To assess their roles as primary treatments, surgical adjuvants, or palliative options.
- To evaluate therapies for prolonging survival in hepatic tumor management.
Main Methods:
- Review of existing literature on alternative hepatic-directed therapies.
- Analysis of therapies used as primary treatment, neoadjuvant therapy, or palliation.
- Inclusion of therapies such as portal vein chemotherapy and hepatic artery infusion.
Main Results:
- Adjuvant portal vein chemotherapy and hepatic artery infusion prolong survival.
- Other therapies like transplantation, chemoembolization, and cryosurgery require further evaluation.
- Heterogeneous patient populations in studies hinder direct comparisons.
Conclusions:
- Non-surgical hepatic-directed therapies are vital for patients unsuitable for resection.
- Established therapies show survival benefits, while others need more research.
- Cost-effectiveness of screening for adjuvant therapy in colorectal metastases requires consideration.