Surgical therapy for metastatic disease to the liver.
The liver is a common site of hematogenous metastasis. In the past, patients with liver metastases were often deemed inoperable, and medical therapy conferred only minor survival benefit. However, advances in surgical techniques and chemotherapeutic agents during the past two decades have led to effective treatments for selected patients with metastases to the liver. Up to approximately 80% of the liver can be resected, and partial hepatectomy is now routinely performed with a perioperative mortality rate of <5%. Surgical resection of colorectal cancer metastatic to the liver results in a 5-year survival rate of 40%. These results are expected to improve even further with multimodality approaches that include newer chemotherapy regimens. Liver metastases from other primary tumors, such as neuroendocrine carcinoma and genitourinary tumors, are also treated effectively with liver resection. The indications for surgical treatment of liver metastases are broadening as a variety of novel therapies are being developed, including hepatic artery embolization, hepatic artery infusion of chemotherapy, and radiofrequency ablation.
Bentrem
David J
DJ
Hepatobiliary Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Dematteo
Ronald P
RP
Blumgart
Leslie H
LH
D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D003131:Combined Modality Therapy; D005240:Feasibility Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D015996:Survival Rate; D014565:Urogenital Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery