Home

Therapy for Liver Metastisis

Surgery is currently considered the "gold standard" treatment for stage IV patients having limited liver/lung metastases and is potentially curative (in about 1/3 of patients who are eligible for liver resection). The Fong/Blumgart paper contains the details and other references.

Many patients are not eligible for this potentially curative surgery due to size/location of liver metastases. There are several new options for these patients detailed below, such as Radiofrequency ablation, Hepatic Arterial Infusion Pump, and Stereotactic Radioablation.

Overview


1. 6/4/01 TITLE: Hepatic colorectal metastasis: current status of surgical therapy. (ABSTRACT) --- FULL TEXT AUTHOR: Fong Y, Blumgart LH SOURCE: Oncology (Huntingt); 12(10):1489-98; discussion 1498-500, 1503 1998 UI: 99014936
   Notes: This paper was recommended to me by a liver surgeon. It gives a lot of references, complications of liver resection, predictors of recurrence. It also notes that "no prospective, randomized study has examined the utility of adjuvant chemotherapy after hepatic resection of metastatic colorectal cancer. Moreover, data from the 4 retrospective studies that have been reported are far from conclusive. Two studies demonstrated no benefit of adjuvant therapy, while the other two suggested a benefit"
   ABSTRACT: Metastatic colorectal cancer to the liver develops in over 50,000 US patients each year and is rapidly fatal if untreated. Even the most active chemotherapeutic agents rarely prolong survival for more than 3 years. Liver resection is the only potentially curative treatment, affording 5-year survival in one-third of patients. The only absolute contraindications to liver resection are poor general health, clear evidence of wide disease dissemination, or inability to resect all liver disease. Close follow-up is warranted after liver resection since disease recurs in two-thirds of patients and recurrences can be successfully treated, possibly with curative potential. Cryosurgery is a promising ablative modality that needs to be compared to chemotherapy but has not been proven to be curative.
   
   
2. 6/23/01 Resection for Liver and Biliary Cancers Summary from the University of Pittsburg. Short article covering types of resections, complications, what to expect from the procedure, etc.
   
   
3. 6/23/01 LIVER RESECTION FOR METASTATIC COLON CANCER Collection of abstracts from the medical literature
   
   
4. 8/4/02 Minimally invasive treatment of colorectal cancer metastases: Current status and new directions BC Medical Journal Volume 42, Number 10, December 2000, pages 461-464 Minimally invasive interventional radiologic treatment for liver cancer, both primary and secondary, has evolved rapidly over the past decade. This article focuses on the status of treatment for colorectal cancer metastases to the liver. Historically, patients presenting with colorectal cancer metastases to the liver are deemed suitable for curative resection only 30% of the time. As a result, there has been significant interest and research in the field of minimally invasive treatment for patients with colorectal cancer metastases to the liver. The authors present the status of the various modalities and discuss each technique, with particular emphasis on radiofrequency ablation and chemoembolization
   
   
5. 8/4/02 THERMAL ABLATION OF LIVER TUMOURS Prof. Andrew Adam, M.D. (PDF file)
   
   
6. 6/23/01 Therapeutic Options for Treating Advanced Colorectal Cancer Clinical Journal of Oncology Nursing - September/October 2000 - Volume 4, Number 5
   
   
7. 6/23/01 Cancer of the Liver Article covers primary and secondary liver cancer, treatments, causes, symptoms, diagnosis, diagnostic tests, etc.
   
   

   ---

   Hepatic Arterial Infusion Pump (HAI)
   
   Go to Page
   
   

   ---

   Radiofrequency Ablation (RFA) Go to Page
   
   

   ---

   ---

   Stereotactic Radioablation/Conformal Radiotherapy Go to Page
   
   

   ---

   Therasphere Go to Page
   
   

   ---

   Cryosurgery
   
   Cryosurgery seems to have fallen out of favor recently, with the advent of Radiofrequency Ablation (RFA), which has fewer side effects and appears more efficacious.
   
   
8. 04/20/01 Cryosurgery
   
   
9. 04/20/01 Cryosurgery - ASCO Abstract 1997
   
   
10. 04/20/01 Abstract - Adam R, Akpinar E, Johann M, et al.: Place of cryosurgery in the treatment of malignant liver tumors. Annals of Surgery 225(1): 39-50, 1997.
    
    
11. 04/20/01 Abstract - Korpan NN: Hepatic cryosurgery for liver metastases: long-term follow-up. Annals of Surgery 225(2): 193-201, 1997.
    
    
12. 04/20/01 Abstract - Ravikumar TS, Steele G, Kane R, et al.: Experimental and clinical observations on hepatic cryosurgery for colorectal metastases. Cancer Research 51(23, Part 1): 6323-6327, 1991.
    
    

Home