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Management of hepatic metastases
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Liver Transplantation and Surgery : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|January 5, 1999
Summary
Surgical resection offers the only potential cure for selected patients with liver metastases from colorectal cancer, with 5-year survival rates up to 46%. Other treatments like chemotherapy and ablation are considered for unresectable or adjuvant cases.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Medical Oncology
Background:
- The liver is a common site for metastatic disease from various cancers.
- Isolated liver metastases are most frequent from colorectal cancer, followed by neuroendocrine tumors and others.
- Comprehensive staging of metastatic disease is crucial for treatment planning.
Purpose of the Study:
- To review current management strategies for isolated liver metastases.
- To evaluate the efficacy of surgical resection and other treatment modalities.
- To emphasize individualized treatment for non-colorectal hepatic metastases.
Main Methods:
- Review of uncontrolled studies on hepatic metastatic colorectal carcinoma.
- Analysis of survival rates following surgical resection.
- Discussion of systemic and hepatic arterial infusion chemotherapy.
- Consideration of local tumor ablation techniques (cryotherapy, radiofrequency ablation).
Main Results:
- Surgical resection offers the only potential cure for selected patients with completely resected colorectal liver metastases.
- Five-year survival rates after resection range from 25% to 46%.
- Chemotherapy and ablation techniques show promise but require further validation.
Conclusions:
- Surgical resection is the primary curative option for select patients with colorectal liver metastases.
- Systemic and intra-arterial chemotherapy are options for unresectable disease or as adjuvant therapy.
- Management of hepatic metastases from other primary tumors requires an individualized approach.