Diagnosis and treatment of metastatic disease to the liver.

Abstract:

:A number of cancers present with synchronous or metachronous hepatic metastases. Historically, many of these patients were considered unresectable and were treated with either systemic chemotherapy or supportive care. Today, a variety of options exist for the management of hepatic metastases. Newer agents for systemic therapy continue to be introduced and are providing improved progression-free and overall survival and increased resectability of liver metastases. However, complete surgical resection of isolated hepatic metastases remains the optimal management for these patients. Surgical interventions can be offered to patients with hepatic-only metastases. Hepatic artery chemotherapy represents an adjunct for those patients undergoing resection and can improve survival. This benefit may be even more pronounced when combined with systemic chemotherapy. Newer generation biologic agents can improve results. New therapeutic modalities to treat lesions that are unresectable include ablative techniques such as radiofrequency ablation (RFA) and cryoablation. This article will examine modalities of diagnosis of hepatic metastases and highlight the data regarding hepatic resection for metastases of several types of primary cancers, the rationale for, and efficacy of, hepatic arterial chemotherapy, in both the postoperative adjuvant setting and in unresectable liver disease, and review the current literature for ablative techniques in the treatment of liver metastases.

journal_name

Semin Oncol

journal_title

Seminars in oncology

authors

Arciero CA,Sigurdson ER

doi

10.1053/j.seminoncol.2007.12.004

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

147-59

issue

2

eissn

0093-7754

issn

1532-8708

pii

S0093-7754(07)00273-4

journal_volume

35

pub_type

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