Management of Hepatic Metastases from Colorectal Cancer

ABSTRACT

The majority of hepatic metastases in the United States occur in patients with a primary colorectal malignancy. Advances in technology combined with increasing surgeon experience have broadened the treatment options available for hepatic metastases from colorectal cancer. Surgical resection is the most effective therapy for metastatic colorectal cancer isolated to the liver. The aim of this article is to discuss the role of locally aggressive treatment options including resection, ablation, and regional chemotherapy in the management of patients with metastases from colorectal cancer.

KEYWORDS

Hepatic metastases - colorectal cancer - hepatic resection - hepatic ablation

REFERENCES

• 1 Jemal A, Thomas A, Murray T et al.. Cancer statistics.  CA Cancer J Clin. 2002;  52 23-47
• 2 Bengmark S, Hafstrom L. The natural history of primary and secondary malignant tumors of the liver. I. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma by laparotomy.  Cancer. 1969;  23 198-202
• 3 Cady B, Monson D, Swinton N. Survival of patients after colonic resection for carcinoma with simultaneous liver metastases.  Surg Gynecol Obstet. 1970;  131 697-700
• 4 Scoggins C, Meszoely I, Blanke C et al.. Nonoperative management of primary colorectal cancer in patients with stage IV disease.  Ann Surg Oncol. 1999;  6 651-657
• 5 Ohlsson B, Tranberg K, Lundstedt C et al.. Detection of hepatic metastases in colorectal cancer: a prospective study of laboratory and imaging methods.  Eur J Surg. 1993;  159 275-281
• 6 Finlay I, McArdle C S. Occult hepatic metastases in colorectal carcinoma.  Br J Surg. 1986;  73 732-735
• 7 Lefor A, Hughes K, Shiloni E et al.. Intra-abdominal extrahepatic disease in patients with colorectal hepatic metastases.  Dis Colon Rectum. 1988;  31 100-103
• 8 Ries L, Miller B, Hankey B et al.. SEER Cancer Statistics Review, 1973-1991: Tables and Graphs. Report no. NIH-94-2789. Bethesda, MD; National Cancer Institute 1994
• 9 Jessup J, McGinnis L, Steele G J et al.. The national cancer data base report on colon cancer.  Cancer. 1996;  78 918-926
• 10 Moertel C, Fleming T, MacDonald J et al.. Fluorouracil plus levamisole as effective adjuvant therapy after resection of stage III colon carcinoma: a final report.  Ann Intern Med. 1995;  122 321-326
• 11 Shelton A, Wong W. Colorectal cancer. In: Cameron J Current Surgical Therapy St. Louis; Mosby 1998: 217-227
• 12 Martin R, Paty P, Fong Y et al.. Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis.  J Am Coll Surg. 2003;  197 233-242
• 13 Blumgart L H, Allison D J. Resection and embolization in the management of secondary hepatic tumors.  World J Surg. 1982;  6 32-45
• 14 Fong Y, Fortner J, Sun R L et al.. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases.  Ann Surg. 1999;  230 309-318
• 15 Fong Y, Blumgart L H. Hepatic colorectal metastases: current status of surgical therapy.  Oncology. 1998;  12 1489-1498
• 16 Fong Y, Cohen A M, Fortner J G et al.. Liver resection for colorectal metastases.  J Clin Oncol. 1997;  15 938-946
• 17 Scheele J, Stangl R, Altendorf-Hofmann A. Hepatic metastases from colorectal carcinoma: impact of surgical resection on the natural history.  Br J Surg. 1990;  77 1241-1246
• 18 Wagner J, Adson M, van Heerden J et al.. The natural history of hepatic metastases from colorectal cancer.  Ann Surg. 1984;  199 502-508
• 19 Rougier P, Milan C, Lazorthes F et al.. Prospective study of prognostic factors in patients with unresected hepatic metastases from colorectal cancer.  Br J Surg. 1995;  82 1397-1400
• 20 Lahr C, Soong S, Cloud G et al.. A multifactorial analysis of prognostic factors in patients with liver metastases from colorectal carcinoma.  J Clin Oncol. 1983;  1 720-725
• 21 Wood C, Gillis C, Blumgart L. A retrospective study of the natural history of patients with liver metastases from colorectal cancer.  Clin Oncol. 1976;  2 285-288
• 22 Pestana C, Reitemeier R, Moertel C et al.. The natural history of carcinoma of the colon and rectum.  Am J Surg. 1964;  108 826-829
• 23 Welch J, Donaldson G. The clinical correlation of an autopsy study of recurrent colorectal cancer.  Ann Surg. 1979;  189 496-502
• 24 Gilbert H, Kagan A. Metastases: incidence, detection, and evaluation without histologic confirmation. In: Weiss L Fundamental Aspects of Metastasis Amsterdam; North-Holland Publishing 1976: 385-405
• 25 Scheele J, Stang R, Atendorf-Hofmann A, Paul M. Resection of colorectal liver metastases.  World J Surg. 1995;  19 59-71
• 26 Moran B, O'Rourke N, Plant G, Rees M. Computed tomographic portography in preoperative imaging of hepatic neoplasms.  Br J Surg. 1995;  82 669-671
• 27 McDermott V, Lawrance J, Paulson E et al.. CT during arterial portography: comparison of injection into the splenic versus superior mesenteric artery.  Radiology. 1996;  199 627-631
• 28 Fernandez F G, Drebin J A, Linehan D C et al.. Five-year survival after resection of hepatic metastases from colorectal cancer in patients screened by positron emission tomography with F-18 fluorodeoxyglucose(FDG-PET).  Ann Surg. 2004;  240 438-450
• 29 Soyer P, Levesque M, Elias D. Detection of liver metastases from colorectal cancer: comparison of intraoperative ultrasound and CT during arterial portography.  Radiology. 1992;  183 541-544
• 30 Conlon R, Jacobs M, Dasgupta D et al.. The value of intraoperative ultrasound during hepatic resection compared with improved preoperative MRI.  Eur J Ultrasound. 2003;  16 211-216
• 31 Grobmyer S R, Fong Y, D’Angelica M et al.. Diagnostic laparoscopy prior to planned hepatic resection for colorectal metastases.  Arch Surg. 2004;  139 1326-1330
• 32 Expectancy or primary chemotherapy in patients with advanced asymptomatic colorectal cancer: a randomized trial. Nordic Gastrointestinal Tumor Adjuvant Therapy Group.  J Clin Oncol. 1992;  10 904-911
• 33 Scheithauer W, Rosen H, Kornek G et al.. Randomised comparison of combination chemotherapy plus supportive care with supportive care alone in patients with metastatic colorectal cancer.  BMJ. 1993;  306 752-755
• 34 Saltz L, Shimada Y, Khayat D. CPT-11 (irinotecan) and 5-fluorouracil: a promising combination for therapy of colorectal cancer.  Eur J Cancer. 1996;  32A(suppl 3) S24-S31
• 35 Adam R. Chemotherapy and surgery: new perspectives on the treatment of unresectable liver metastases.  Ann Oncol. 2003;  14 13-16
• 36 Leonard G D, Brenner B, Kemeny N. Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma.  J Clin Oncol. 2005;  23 2038-2048
• 37 Hurwitz H, Fehrenbacher L, Novotny W et al.. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer.  N Engl J Med. 2004;  350 2335-2342
• 38 Hamady Z Z, Kotru A, Nishio H et al.. Current techniques and results of liver resection for colorectal liver metastases.  Br Med Bull. 2004;  70 87-104
• 39 Elias D, Oullet J F, De Baere T et al.. Pre-operative selective portal vein embolization before hepatectomy for liver metastases.  Surgery. 2002;  131 294-299
• 40 Adam R, Laurent A, Azoulay D et al.. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors.  Ann Surg. 2000;  232 777-785
• 41 Minagawa M, Makuuchi M, Torzilli G et al.. Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results.  Ann Surg. 2000;  231 487-499
• 42 Ambiru S, Miyazaki M, Isono T et al.. Hepatic resection for colorectal metastases: analysis of prognostic factors.  Dis Colon Rectum. 1999;  42 632-639
• 43 Jamison R, Donohue J, Nagorney D et al.. Hepatic resection for metastatic colorectal cancer results in cure for some.  Arch Surg. 1997;  132 505-511
• 44 Gayowski T, Iwatsuki S, Madariaga J et al.. Experience in hepatic resection for metastatic colorectal cancer: analysis of clinical and pathologic risk factors.  Surgery. 1994;  116 703-711
• 45 Doci R, Bignami P, Montalto F, Gennari L. Prognostic factors for survival and disease-free survival in hepatic metastases from colorectal cancer treated by resection.  Tumori. 1995;  81(3 suppl) 143-146
• 46 Jaeck D, Bachellier P, Guiguet M et al.. Survival benefit of repeat liver resection for recurrent colorectal metastases: 143 cases.  Wiad Lek. 1997;  50(suppl 1) 102-104
• 47 Fong Y, Blumgart L, Cohen A et al.. Repeat hepatic resections for metastatic colorectal cancer.  Ann Surg. 1994;  220 657-662
• 48 Fernandez-Trigo V, Shamsa F, Sugarbaker P. Repeat liver resections from colorectal metastasis. Repeat Hepatic Metastases Registry.  Surgery. 1995;  117 296-304
• 49 Petrowsky H, Gonen M, Jarnigan W et al.. Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis.  Ann Surg. 2002;  235 863-871
• 50 Choti M A, Sitzmann J V, Tiburi M F et al.. Trends in long term survival following liver resection for hepatic colorectal metastases.  Ann Surg. 2002;  235 759-766
• 51 Ng K K, Poon R T. Radiofrequency ablation for malignant liver tumor.  Surg Oncol. 2005;  14 41-52
• 52 Abdalla E K, Vauthey J N, Ellis L M et al.. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases.  Ann Surg. 2004;  239 818-827
• 53 Wood T F, Rose D M, Chung M et al.. Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limits, and complications.  Ann Surg Oncol. 2000;  7 593-600
• 54 Bowles B J, Machi J, Limm W ML et al.. Safety and efficacy of radiofrequency thermal ablation in advanced liver tumors.  Arch Surg. 2001;  136 864-869
• 55 Curley S A, Izzo F, Ellis L M et al.. Radiofrequency ablation of hepatocellular cancer in 110 patients with cirrhosis.  Ann Surg. 2000;  232 381-391
• 56 Barber F D, Mavligit G, Kurzock R. Hepatic arterial infusion chemotherapy for metastatic colorectal cancer: a concise overview.  Cancer Treat Rev. 2004;  30 425-436
• 57 Onaitis M, Morse M, Hurwitz H et al.. Adjuvant hepatic arterial chemotherapy following metastasectomy in patients with isolated liver metastases.  Ann Surg. 2003;  237 782-788
• 58 Martin R C, Edwards M J, McMasters K M. Morbidity of adjuvant hepatic arterial infusion pump chemotherapy in the management of colorectal cancer metastatic to the liver.  Am J Surg. 2004;  188 714-721