| Theme |
Diversified Modalities of Liver Metastasis Treatment |
| Title |
Current Status of Liver Resection for Metastatic Tumors |
| Author |
Takeaki Ishizawa |
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| Author |
Kiyoshi Hasegawa |
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| Author |
Norihiro Kokudo |
Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo |
| [ Summary ] |
Liver resection is the established first-line treatment for liver metastases associated with colorectal cancer and neuroendocrine tumors, since these tumors tend to be localized in the liver, lung, and/or regional lymph nodes. Liver resection can be safely implemented even for patients with multiple or bilobar colorectal liver metastases, if proper liver function permits resection. When remnant liver volume is projected to be insufficient, preoperative portal vein embolization may be indicated, in order to perform hemihepatectomies and partial resections of the contralateral lobe. Recent advances in chemotherapy may further enhance long-term results after resection of colorectal liver metastases, improving resection rates and postoperative recurrence rates. However, care should be taken to avoid chemotherapy-induced hepatic toxicity. The use of radiofrequency ablation for colorectal liver metastases should be limited to selected patients, because it often increases complications with liver resection in terms of possible recurrence. |