Surgical and multimodality approaches to liver metastases.

Abstract

Although liver metastases may provide the first evidence of cancer progression, they almost always indicate general dissemination of malignancy. Treatment options for hepatic metastases include surgical resection, administration of regional chemotherapy, systemic chemotherapy, radiotherapy, and various innovative strategies to achieve specific drug targeting. In spite of all advances, surgery is currently the only therapy that prolongs survival or even provides the chance of cure. Technical standards constitute no longer a limiting factor in the use of hepatic resection for malignant disease. Although hepatic resection remains a major procedure, current mortality rates of 0%–6% justify widespread use of this type of surgery (Foster and Lundy 1981; Gayowski et al. 1994). Consequently, it is now even more important to establish accurate guidelines defining the indications of hepatic resection for malignant disease.