[Therapeutically options for primary and secondary hepatic malignancies].
Therapeutically options for the treatment of patients with primary hepatic malignancies have grown in recent years. Apart from liver resection and organ transplantation, representing the only curative strategies for primary hepatic malignancies, a variety of palliative procedures have been introduced. Some of these result in extended patient survival. However, the combination of a malignant disease and an irreversible organ damage remains to be the main problem in the majority of patients with primary liver Cancer. Liver resection is the only curative therapy for patients with isolated hepatic colorectal metastases and can be performed with low morbidity and mortality if a correct indication and a standardized procedure is applied. In case of intrahepatic tumour recurrence re-resection is indicated as long as extrahepatic metastases can be excluded. In patients with primary unresectable metastases a downstaging-chemotherapy, two-stage hepatectomy or portal vene embolization might result in a secondary respectability. Locally ablative procedures are being evaluated at present, in the palliative Situation survival can be prolonged. In the future multimodal therapeutic approaches will dominate the treatment of primary and secondary hepatic malignancies.
Chirurgische Klinik I, Zentrum für Operative Medizin, Universitätsklinikum Würzburg, Deutschland. stephan.timm@mail.uni-wuerzburg.de
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Timm
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Gassel
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Moll
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Thiede
D015179:Colorectal Neoplasms / Q000473:pathology; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D010166:Palliative Care