[Surgical prospects for liver metastases].
The recent advances in liver surgery have made it possible to perform liver resections in an increasing number of patients with consequent improvement in the results. This coincides with an amplification of the indications to liver surgery for metastases. Besides the development of radiological procedures as applied to liver surgery and more effective chemotherapy protocols, the actual approach to patients with liver metastases is shared by three figures - the surgeon, the radiologist and the oncologist. Currently it has been shown that liver resections for metastases are possible with a meaningful increase of survival in the case of colorectal and neuroendocrine liver metastases and in selected cases of non-colorectal non-neuroendocrine metastases. From the technical point of view the most remarkable aspect is the possibility of expanding the criteria of resectability by means of liver resections in one or two steps associated with portal vein embolisation or ligation of a portal branch. It is also possible to perform iterative liver resections and liver transplantation in selected cases of neuroendocrine liver metastases.
Vennarecci
Giovanni
G
Divisione di Chirurgia Digestiva Oncologica e dei Trapianti di Fegato Dipartimento di Chirurgia Oncologica, Istituto Regina Elena, Roma.
Ettorre
Giuseppe Maria
GM
Lorusso
Riccardo
R
Santoro
Roberto
R
Visco
Giuseppe
G
Santoro
Eugenio
E
D002404:Catheterization / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology*; D004621:Embolization, Therapeutic; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D018358:Neuroendocrine Tumors / Q000556:secondary* / Q000601:surgery*; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome