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Metastatic Liver Tumors: Colorectal Cancer

Of the 160,000 patients seen yearly in the United States with colon cancer, as many as 40 to 50 percent will eventually develop liver metastases. Unfortunately, fewer than 15,000 of these patients will have liver metastases as their sole site of recurrence, and only one-third of these are candidates for surgery. As with primary liver cancer, the best chance for cure is resection of the tumors. It is important that a surgeon with experience in liver surgery evaluates patients with suspected colorectal liver metastases to determine whether the tumor is resectable. Some patients with metastatic colorectal cancer to the liver can enjoy long-term survival if the tumors are completely resected.

Pre-treatment colorectal liver metastases

Liver metastases following hepatic arterial pump chemotherapy.

Systemic chemotherapy is the most widely employed treatment for unresectable liver metastases. Other modalities currently under investigation at Ellis Fischel Cancer Center include regional hepatic arterial infusional chemotherapy and cryosurgical ablation. Hepatic arterial chemotherapy is administered via a surgically implanted pump. In this manner, larger doses of chemotherapy can be administered with higher tumor response rates.

Cryosurgical ablation of selected metastatic liver tumors also is available, both alone and in conjunction with surgical resection or HAI chemotherapy. The liver tumor group at Ellis Fischel is currently investigating whether unresectable tumors that may be too large to freeze initially can be downsized by intra-arterial chemotherapy and subsequently frozen.

Cryosurgical ablation of colorectal liver metastasis

Intraoperative ultrasound of cryosurgical tumor ablation.