Qiang Gao*, Zhenggang Ren, Jia Fan and Diyang Xie
Department of Liver Surgery, Liver Cancer Institute, Fudan University, ChinaFulltext PDF
Liver metastases are accountable for a high mortality and morbidity in patients with metastatic diseases. The majority of liver metastases are derived from colorectal, gastric and neuroendocrine primary tumors. Resection is the only potentially curative approach to selected colorectal liver metastases (CRLM) and neuroendocrine liver metastases (NELM). Improvements in systemic therapies and operative technologies have succeeded in converting some borderline unresectable cases to resectable, resulting in a more favorable overall survival. For unresectable CRLM or NELM because of the size, location or comorbidities, other locoregional treatments including ablation, intraatrial therapy and stereotactic body radiotherapy can serve as an alternative with proved efficacy and safety. Evidences on locoregional strategies for non-colorectal, non-neuroendocrine liver metastases (NCNELM) are scarce and warrant large randomized controlled trials for verification. Resection has been indicated as a curative attempt for highly selected gastric liver metastases in Eastern centers. Systemic therapy remains the cornerstone for metastatic diseases. The optimal management of liver metastases requires a multidisciplinary team to form an individualized therapeutic approach. This article evaluates current evidences on the management of liver metastases, with an emphasis on liver-directed local treatment.
Gao Q, Ren Z, Fan J, Xie D. Local and Systemic Therapies for Liver Metastases. Clin Surg. 2016; 1: 1225.