Colorectal liver metastases
Incidence
Colorectal (colon and rectum, or entire large bowel) cancer is the fourth
most common malignancy, behind cancers of the lung, breast and prostate.
Worldwide, colorectal cancer strikes approximately 850,000 people each
year and accounts for over 500,000 annual deaths. Up to 70% of patients
with colorectal cancer eventually develop liver metastases. In 30-40%
of those patients with metastases, it is still confined to the liver
at the time of metastatic diagnosis. Of the patients with colorectal
metastases confined to the liver, only 25% are surgical candidates due
to size, distribution or accessibility of the tumor(s).
Promising
developments in minimally invasive intervention, however, do offer local
treatment options for patients with unresectable liver metastases confined
to the liver. This is the focus of this web site.
Prognosis
By definition,
patients with metastatic disease have advanced stage disease. Surgical
resection is now a widely accepted treatment for colorectal metastases
to the liver. Five-year survival rates are consistently reported between
20% and 35% for patients whose cancer is confined to the liver and is
surgically accessible. By contrast, patients with similar disease who
could not tolerate surgery, and did not receive any other treatment
except systemic chemotherapy, rarely survived for five years.
Neuroendocrine
liver metastases
Neuroendocrine tumors are slow growing tumors that are most often discovered
when they have multiple metastatic deposits within the liver, or outside
the liver (extrahepatic), making them unresectable. Because of hormone
secretion, these patients experience higher death rates.
Even though
few patients with metastatic neuroendocrine tumors are appropriate for
resection, significant symptom relief can be accomplished by treatments
intended to reduce, if not eliminate, the tumor. Treatment options include
hepatic artery ligation and chemoembolization to limit the sustaining
blood supply to the tumor(s) as well as local ablation techniques including
radiofrequency ablation, alcohol injection and cryotherapy.
However,
in patients with resectable disease, resection may delay the most debilitating
symptoms for several years. A 1996 study reported five-year survival
rates of 79%, with 52% of these patients not experiencing any recurrence
during this period.
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Last modified: Friday, October 10, 2003