Abstract
The liver is the most common site of metastasis in patients with colorectal cancer due to its anatomical situation regarding its portal circulation. About 14 to 18% of patients with colorectal cancer present metastasis at the first medical consultation, and 10 to 25% at the time of the resection of the primary colorectal cancer. The incidence is higher (35%) when a computed tomography (CT) scan is used.In the last decades, a significant increase in the life expectancy of patients with colorectal cancer has been achieved with different diagnostic and treatment programs. Despite these improvements, the presence of metastasis, disease recurrence, and advanced local tumors continue to remain poor prognostic factors.Median survival without treatment is <8 months from the moment of its presentation, and a survival rate at 5 years of 11% is the best prognosis for those who present with local metastasis. Even in patients with limited metastatic disease, 5-year survival is exceptional. Patients with hepatic metastasis of colorectal cancer have a median survival of 5 to 20 months with no treatment. Approximately 20 to 30% of patients with colorectal metastasis have disease confined to the liver, and this can be managed with surgery. Modern surgical strategies at the main hepatobiliary centers have proved that hepatectomy of 70% of the liver can be performed, with a mortality rate of <5%.It is very important to have knowledge of predisposing factors, diagnostic methods, and treatment of hepatic metastasis. However, the establishment of newer, efficient, preventive screening programs for early diagnosis and adequate treatment is vital.How to cite this article: Valderrama-Treviño AI, Barrera-Mera B, Ceballos-Villalva JC, Montalvo-Javé EE. Hepatic Metastasis from Colorectal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(2):166-175.
Highlights
Colorectal cancer is the third most common cancer in the world in terms of incidence and the fourth in mortality,[1] immediately behind lung, liver, and stomach cancer.[2]
Poor prognostic factors continue to include the presence of metastasis, disease recurrence, and advanced localized tumors,[9] reporting that one-half of these patients with these risk factors die in the presence of these neoplasms.[10]
Another highly expressed gene in hepatic metastasis is PIAS2, a protein inhibitor of the activated STAT2 that causes a stop in the cell cycle and acts as a transcription factor that controls deoxyribonucleic acid (DNA)-associated damage through several cellular pathways, such as STAT, Myc, and TP53.34 Understanding the mechanisms by which metastases are developed in the liver possesses great clinical significance
Summary
Colorectal cancer is the third most common cancer in the world in terms of incidence and the fourth in mortality,[1] immediately behind lung, liver, and stomach cancer.[2]. An increase in the life expectancy of patients with colorectal cancer has been achieved, with screening, early diagnosis, novel chemotherapy agents, and improvements in radiotherapy and in surgical techniques. Despite these improvements, poor prognostic factors continue to include the presence of metastasis, disease recurrence, and advanced localized tumors,[9] reporting that one-half of these patients with these risk factors die in the presence of these neoplasms.[10] Colorectal cancer is one of the most common diseases, with approximately one million new cases and 500,000 deaths annually worldwide, the main cause of death being metastasis. Size, the amount of metastases in the liver, normal residual liver, and the additional hepatic disease, 85% of these patients are not eligible for surgery.[10]
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