Liver resection post-selective internal radiation therapy – an overview

Abstract

Surgical resection of primary and secondary liver tumours or liver transplantation are the only potentially curative options. However, only a minority of patients (15−25%) with primary hepatocellular carcinoma, intrahepatic cholangiocarcinoma, colorectal liver metastases, neuroendocrine metastases and non-colorectal and nonneuroendocrine metastases are suitable for surgical resection. There remains debate about the definition of resectability, but this is broadly acknowledged to be complete removal of all tumour (R0 resection) whilst leaving sufficient functioning liver remnant (approximately 25% of the liver) for post-operative survival. The balance of tumour clearance and residual liver parenchyma is dictated by the anatomical distribution of the tumours and the function of the underlying liver parenchyma. The value of liver resection for colorectal metastases is reported by the Liver Met Survey database (www.livermetssurvey.com). There is however, wide