Skip to main content

Liver Metastases

  • Chapter
  • First Online:
Induction Chemotherapy

Abstract

The worldwide incidence of cancer is increasing, and with it the incidence of metastatic disease to the liver. The commonest treatable liver metastasis is from cancer of the colon or rectum. Traditionally, only 20–30% of patients presenting with colorectal liver metastases were eligible for surgical resection with curative intent. Refinements in imaging, anaesthesia, surgical techniques and chemotherapeutic regimes have led to an expansion in eligibility for resection. Preoperative chemotherapy can downstage tumours for curative resection and results from recent studies are encouraging. Here we provide an overview of the current status of induction chemotherapy for liver metastases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.

    Article  PubMed  Google Scholar 

  2. Wagner JS, Adson MA, Van Heerden JA, Adson MH, Ilstrup DM. The natural history of hepatic metastases from colorectal cancer. A comparison with resective treatment. Ann Surg. 1984;199:502–8.

    Article  PubMed  CAS  Google Scholar 

  3. Scheithauer W, Rosen H, Vornek GV, Sebesta C, Depisch D. Randomised comparison of combination chemotherapy plus supportive care with supportive care alone in patients with metastatic colorectal cancer. BMJ. 1993;306:752–5.

    Article  PubMed  CAS  Google Scholar 

  4. Bodingbauer M, Tamandi D, Schmid K, Plank C, Schima W, Gruenberger T. Size of surgical margin does not influence recurrence rates after curative liver resection for colorectal cancer liver metastases. Br J Surg. 2007;94:1133–8.

    Article  PubMed  CAS  Google Scholar 

  5. Lordan JT, Karanjia ND. ‘Close shave’ in liver resection for colorectal liver metastases. Eur J Surg Oncol. 2010;36:47–51.

    Article  PubMed  CAS  Google Scholar 

  6. Scheele J, Stang E, Altendorf-Horfmann A, Paul MA. Resection of colorectal liver metastases. World J Surg. 1995;19:59–71.

    Article  PubMed  CAS  Google Scholar 

  7. Nordlinger B, Guiguet M, Vaillant JC, Balladur P, Boudjema K, Bachellier P, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer. 1996;77(7):1254–62.

    Article  PubMed  CAS  Google Scholar 

  8. Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230:309–18.

    Article  PubMed  CAS  Google Scholar 

  9. Wong SL, Mangu PB, Choti MA, Crocenzi TS, Dodd 3rd GD, Dorfman GS, et al. American Society of Clinical Oncology 2009 clinical evidence review on radiofrequency ablation of hepatic metastases from colorectal cancer. J Clin Oncol. 2010;20:493–508.

    Article  Google Scholar 

  10. Stang A, Fischbach R, Teichmann W, Bokemeyer C, Braumann D. A systematic review on the clinical benefit and role of radiofrequency ablation as treatment of colorectal liver metastases. Eur J Cancer. 2009;45:1748–56.

    Article  PubMed  Google Scholar 

  11. Douillard JY, Cunningham D, Roth AD, Navarro M, James RD, Karasek P, et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet. 2000;355:1041–7.

    Article  PubMed  CAS  Google Scholar 

  12. De Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, et al. Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol. 2000;18:2938–47.

    PubMed  Google Scholar 

  13. Tournigand C, Andre T, Achille E, Lledo G, Flesh M, Mery-Mignard D, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol. 2004;22:229–37.

    Article  PubMed  CAS  Google Scholar 

  14. Cassidy J, Tabernero J, Twelves C, Brunet R, Butts C, Conroy T, et al. XELOX (capecitabine plus oxaliplatin): active first-line therapy for patients with metastatic colorectal cancer. J Clin Oncol. 2004;22:2084–91.

    Article  PubMed  CAS  Google Scholar 

  15. Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004;350:2335–42.

    Article  PubMed  CAS  Google Scholar 

  16. Van Cutsem E, Köhne CH, Hitre E, Zaluski J, Chang Chien CR, Makhson A, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360:1408–17.

    Article  PubMed  Google Scholar 

  17. Ridge JA, Bading JR, Gelbard AS, Benua RS, Daly JM. Perfusion of colorectal hepatic metastases. Relative distribution of flow from the hepatic artery and portal vein. Cancer. 1987;59(9):1547–53.

    Article  PubMed  CAS  Google Scholar 

  18. Mocellin S, Pasquali S, Nitti D. Fluoropyrimidine-HAI (hepatic arterial infusion) versus systemic chemotherapy (SCT) for unresectable liver metastases from colorectal cancer. Cochrane Database of Systematic Reviews. 2009;3:CD007823.

    Google Scholar 

  19. Vogl TJ, Naguib NN, Zangos S, Eichler K, Hedayati A, Nour-Eldin NE. Liver metastases of neuroendocrine carcinomas: interventional treatment via transarterial embolization, chemoembolization and thermal ablation. Eur J Radiol. 2009;72:517–28.

    Article  PubMed  Google Scholar 

  20. Vogl TJ, Gruber T, Balzer JO, Eichler K, Hammerstingl R, Zangos S. Repeated transarterial chemoembolization in the treatment of liver metastases of colorectal cancer: prospective study. Radiology. 2009;250:281–9.

    Article  PubMed  Google Scholar 

  21. Dawood O, Mahadevan A, Goodman KA. Stereotactic body radiation therapy for liver metastases. Eur J Cancer. 2009;45:2947–59.

    Article  PubMed  Google Scholar 

  22. Cianni R, Urigo C, Notarianni E, Saltarelli A, Salvatori R, Pasqualini V, et al. Selective internal radiation therapy with SIR-spheres for the treatment of unresectable colorectal hepatic metastases. Cardiovasc Intervent Radiol. 2009;32:1179–86.

    Article  PubMed  Google Scholar 

  23. Nicolay NH, Berry DP, Sharma RA. Liver metastases from colorectal cancer: radioembolization with systemic therapy. Nat Rev Clin Oncol. 2009;6:687–967.

    Article  PubMed  CAS  Google Scholar 

  24. Fowler WC, Eisenberg BL, Hoffman JP. Hepatic resection following chemotherapy for metastatic colorectal carcinoma. J Surg Oncol. 1992;51:122–5.

    Article  PubMed  CAS  Google Scholar 

  25. Bismuth H, Adam R, Levi F, Farabos C, Waechter F, Castaing D, et al. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg. 1996;224:509–22.

    Article  PubMed  CAS  Google Scholar 

  26. Nordlinger B, Sorbye H, Glimelius B, Poston GJ, Schlag PM, Rougier P, et al. Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomized controlled trial. Lancet. 2008;371:1007–16.

    Article  PubMed  CAS  Google Scholar 

  27. Reddy SK, Zorzi D, Lum YW, Barbas AS, Pawlik TM, Dibero D, et al. Timing of multimodality therapy for resectable synchronous colorectal liver metastases: a retrospective multi-institutional analysis. Ann Surg Oncol. 2009;16:1809–19.

    Article  PubMed  Google Scholar 

  28. Blazer III DG, Kishi Y, Maru DM, Kopetz S, Chun YS, Overman MJ, et al. Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases. J Clin Oncol. 2008;26(33):5344–51.

    Article  PubMed  Google Scholar 

  29. Adam R, Wicherts DA, de Haas RJ, Aloia T, Levi F, Paule B, et al. Complete pathologic response after preoperative chemo-therapy for colorectal liver metastases: myth or reality? J Clin Oncol. 2008;26:1635–41.

    Article  PubMed  Google Scholar 

  30. Chua TC, Saxena A, Liauw W, Kokandi A, Morris DL. Systematic review of randomized and nonrandomized trials of the clinical response and outcomes of neoadjuvant systemic chemotherapy for resectable colorectal liver metastases. Ann Surg Oncol. 2010;17:492–501.

    Article  PubMed  Google Scholar 

  31. Kemeny N, Jarnagin W, Paty P, Gonen M, Schwartz L, Morse M, et al. Phase I trial of systemic oxaliplatin combination chemotherapy with hepatic arterial infusion in patients with unresectable liver metastases from colorectal cancer. J Clin Oncol. 2005;23:4888–96.

    Article  PubMed  CAS  Google Scholar 

  32. Ducreux M, Ychou M, Laplanche A, Gamelin E, Lasser P, Husseini F, et al. Hepatic arterial oxaliplatin infusion plus intravenous chemotherapy in colorectal cancer with inoperable hepatic metastases: a trial of the gastrointestinal group of the Federation Nationale des Centres de Lutte Contre le Cancer. J Clin Oncol. 2005;23:4881–7.

    Article  PubMed  CAS  Google Scholar 

  33. Adam R, Pascal G, Castaing D, Azoulay D, Delvart V, Paule B, et al. Tumor progression while on chemotherapy: a contraindi- cation to liver resection for multiple colorectal metastases? Ann Surg. 2004;240:1052–61.

    Article  PubMed  Google Scholar 

  34. Chun YS, Laurent A, Vauthey JN. Management of chemotherapy-associated hepatotoxicity in colorectal liver metastases. Lancet Oncol. 2009;10:278–86.

    Article  PubMed  CAS  Google Scholar 

  35. Abulkhir A, Limongelli P, Healey AJ, Damrah O, Tait P, Jackson J, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg. 2008;247:49–57.

    Article  PubMed  Google Scholar 

  36. Sturesson C, Keussen I, Tranberg KG. Prolonged chemotherapy impairs liver regeneration after portal vein occlusion – an audit of 26 patients. Eur J Surg Oncol. 2010;36(4):358–64.

    Article  PubMed  CAS  Google Scholar 

  37. Chun YS, Vauthey JN, Ribero D, Donadon M, Mullen JT, Eng C, et al. Systemic chemotherapy and two-stage hepatectomy for extensive bilateral colorectal liver metastases: perioperative safety and survival. J Gastrointest Surg. 2007;11:1498–504.

    Article  PubMed  Google Scholar 

  38. Welsh FKS, Tilney HS, Tekkis PP, John TG, Rees M. Safe liver resection following chemotherapy for colorectal metastases is a matter of timing. Br J Cancer. 2007;96:1037–42.

    Article  PubMed  CAS  Google Scholar 

  39. Karoui M, Penna C, Amin-Hashem M, Mitry E, Benoist S, Franc B. Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg. 2006;243:1–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David Lawson Morris .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2011 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Habib, M.R., Morris, D.L. (2011). Liver Metastases. In: Aigner, K., Stephens, F. (eds) Induction Chemotherapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18173-3_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18173-3_23

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-18172-6

  • Online ISBN: 978-3-642-18173-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics