Metastasis

Metastasis, or metastatic disease, is the spread of a cancer from one organ or part to another non-adjacent organ or part. The new occurrences of disease thus generated are referred to as metastases. It was previously thought that only malignant tumor cells and infections have the capacity to metastasize; however, this is being reconsidered due to new research.
After the tumor cells come to rest at another site, they re-penetrate the vessel or walls and continue to multiply, eventually forming another clinically detectable tumor. This new tumor is known as a metastatic (or secondary) tumor.

Liver metastasis

Liver metastases develop in nearly 20% of patients with stage II and 50% of patients with stage III colorectal cancer and represent the major cause of death in this disease. Surgical resection remains the only treatment that can, to date, ensure long-term survival and cure in some patients.

Symptoms of Liver Metastases

When symptoms occur, they may include:

  • Anorexia
  • Fevers
  • Jaundice
  • Nausea
  • Pain, usually in the upper right part of the abdomen
  • Sweats
  • Weight loss

Possible Complications

Complications are generally the result of tumors spreading to a large area of the liver. They can include:

  • Blockage of the flow of bile
  • Decreased appetite
  • Fever
  • Liver failure (usually only in the late stages of disease)
  • Pain
  • Weight loss

Treatment

Several treatment options are available for patients with liver metastases, depending on the location of the primary cancer, the number and size of tumors, and the patient’s general health. Most but not all liver metastases begin in the colon and spread to the liver.
Colorectal cancer frequently metastasizes to the liver. Patients presenting with operable liver metastases often receive chemotherapy followed by surgery to remove all visible disease, and then additional chemotherapy to eliminate non-visible microscopic disease. Patients with advanced colorectal cancer whose liver metastases are not amendable to surgery may still benefit from Radiofrequency Ablation (RFA) and Microwave Ablation (MA) and other therapeutic options.

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    Surgery

    Surgery to remove liver tumors (surgical resection) — often in combination with chemotherapy — is the most effective treatment for patients with liver metastases from colorectal cancer that are limited in size and number. Studies suggest that up to 50 percent of patients who undergo surgery to remove colorectal liver metastases survive for at least five years.
    Despite its effectiveness, liver surgery is a challenging procedure since many of the major blood vessels running to and from the heart pass behind or through the liver, essentially connecting these organs. In addition, the liver can tear easily and bleeds profusely when injured.
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    Laparoscopic Surgery

    When possible and appropriate, surgeons use minimally invasive laparoscopic surgery to remove liver tumors. Having laparoscopic surgery can significantly reduce patient recovery time compared with traditional surgery. In this procedure, surgeons insert a thin, lighted tube with a camera on its tip through a tiny incision in the patient’s abdomen. Special surgical instruments are guided through the laparoscope to remove tumors or, in selected cases, part of the liver.