Colorectal liver malignancies

Curley SA (2003) Radiofrequency ablation of malignant liver tumors. Ann Surg Oncol 10 338-347 Curley SA, Marra P, Beaty K et al. (2004) Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients. Ann Surg 239 450-458 de Baere T, Elias D, Dromain C et al. (2000) Radiofrequency ablation of 100 hepatic metastases with a mean follow-up of more than 1 year. AJR Am J Roentgenol 175 1619-1625 Gillams AR, Lees WR (2004) Radio-frequency ablation of colorectal liver metastases in 167 patients. Eur Radiol 14 2261-2267... 

Nagorney DM, van Heerden JA, Ilstrup DM, et al (1989) Primary hepatic malignancy surgical management and determinants of survival. Surgery 106 740-749 National Institute for Clinical Excellence (2003) Radiofrequency ablation of hepatocellular carcinoma. July 2003 Nolsoe CP, Torp-Pedersen S, Burcharth F, et al (1993) Interstitial hyperthermia of colorectal liver metastases with... 

Iwatsuki S, Esquivel C, Gordon RD, et al (1986) Liver resection for metastatic colorectal cancer. Surgery 100 804-810 Jaeck D (2003) The significance of hepatic pedicle lymph node metastases in surgical management of colorectal liver metastases and of other liver malignancies. Ann Surg Oncol 10 1007-1011... 

In a pilot trial with 12 patients with hepatic metastases from colorectal cancer, the concentrations of the curcumin in normal and malignant human liver tissue after patients received 450-3600 mg of curcumin daily for 1 week prior to surgery were not sufficient to elicit pharmacological activity, perhaps because of the extensive degree to which curcumin was metabolized in the intestine. 

Imaging of patients with liver tumors is an important and highly relevant field of diagnostic imaging, due to the large number of patients with diffuse or focal liver disease (e.g., the increasing number of patients with viral hepatitis) or with at least potential involvement of the liver (e.g., patients with extrahepatic malignancies such as breast cancer or colorectal cancer). The aim of... 

Fig. 29.6. CT images in the portovenous phase of two different patients suffering from extrahepatic malignancies with liver metastases. On the kft side, typical hypovascular metastases from a breast cancer are depicted (arrows) the larger lesions show central regressive changes with the corresponding bull s-eye appearance. On the right side, a metastasis from a colorectal carcinoma is shown (arrow). This lesion is also a typical hy-...

The survival reported by numerous groups is comparable with that observed with other abdomi-nopelvic malignancy such as retroperitoneal and visceral sarcoma and liver metastases from colorectal cancer. The survival is far superior to that for some cancers that are routinely resected, such as pancreatic cancer, gallbladder cancer, and cholan-giocarcinoma. By analogy with other standard of practice management plans, the efficacy of these peritoneal carcinosis treatments and the morbidity and mortality are acceptable. 

Primary and secondary malignant hepatic tumors are a major health problem worldwide. While metas-tases are common in western countries, primary liver cancers are frequently diagnosed in Asia and Africa. However, recent data suggest that the incidence and mortality of hepatocellular carcinoma (HCC) in Western nations are on the rise (Taylor-Robinson et al. 1997 Llovet et al. 2003). Likewise, the liver is the most common site for metastases. In 25%-50% of patients with malignancies liver metastases were observed at autopsy (Bernardino et al. 1982). The most frequent primary sites are colon, breast, pancreas, and lung. In the case of colorectal metastatic disease, the liver is the only metastatic site in 20%-30% of patients (Sasson and Sigurdson 2002). 

In the USA, SIRT was approved for the treatment of unresectable primary hepatic malignancies and metastases from colorectal cancer together with intrahepatic artery chemotherapy (IHAC) using floxuridine (FUDR). Nevertheless, worldwide SIRT may be used in patients with hepatic malignancies originating from various primaries, such as neuroendocrine tumors, breast, colorectal, and bronchial cancer, where the disease appears to be limited to the liver and other treatment options are no longer available. 

In patients presenting hepatobiliary malignancies without chronic liver disease, Abdalla et al. reported equivalent median survival durations when they underwent PVE or not prior to extended hepatectomy (> or = 5 segments), respectively 40 and 52 months [2]. We have reported 5-year survival and 5-year disease-free survival of 34% and 24% respectively in 60 patients who underwent PVE for liver metastases, that was comparable with the survival rates obtained after resection without PVE [14]. Compared long-term results from the literature, in specific groups of patients presenting with liver metastases from colorectal primary or with hepatocellular carcinoma, are summarized in Table 13 4. All these studies demonstrated equivalence in 5-year survival and 5-year disease-free survival between groups of patients preoperatively treated by PVE or not (Table 13.4). 

Patt YZ, McBride CM, Ames FC, et al (1987) Adjuvant perioperative hepatic arterial mitomycin C and floxuridine combined with surgical resection of metastatic colorectal cancer in the liver. Cancer 59 867-873 Pawlik TM, Izzo F, Cohen DS, et al (2003) Combined resection and radiofrequency ablation for advanced hepatic malignancies results in 172 patients. Ann Surg Oncol. 10 1059-1069... 

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