Resection for curative intent is the gold standard for metastatic and primary hepatic tumors where feasible. Resectability, as previously discussed in other chapters, is the result of a coalescence of factors: technical/anatomic feasibility, adequacy of the predicted future liver remnant,…
Image-guided ablation techniques have evolved considerably during the past 25 years and are increasingly used in the definitive treatment of small primary and secondary liver tumors. Image-guided ablation is recommended as the best therapeutic choice for patients with early-stage hepatocellular…
Historical context and whole-liver radiation therapy The efficacy of radiation therapy (RT) is predicated on the ability to deliver the tumoricidal RT dose while keeping the dose to the surrounding normal tissues the same. The balance between the probability of…
Overview Interventional oncology is a rapidly growing branch of interventional radiology that is a vital part of multidisciplinary oncologic care. In the management of patients with liver tumors, the minimally invasive nature of its procedures allows targeted delivery of oncologic…
Hepatocellular carcinoma (HCC) is the most common primary liver cancer worldwide (see Chapter 89 ). Despite the widespread implementation of surveillance programs of high-risk populations, only 20% to 30% of HCC patients are candidates for potentially curative surgical treatment, including…
Overview An appreciation of hepatic segmental anatomy (see Chapter 2 ) has led to major advances in hepatic surgery, especially for tumors. In addition, the well-known but still somewhat mysterious stimulus to hepatic regeneration has allowed larger and more extensive…
Overview Only 10% of malignant liver tumors are primary liver or bile duct cancers. The vast majority of cancerous hepatic lesions are metastatic lesions originating from extrahepatic primary tumors (see Chapters 90 and 91 ). The only potentially curative approach…
Overview The liver is the most common site of metastasis for all neuroendocrine neoplasms and second only to regional lymph nodes as the dominant site of metastases from all gastrointestinal (GI) tract malignancies. In patients with neuroendocrine liver metastases (NELMs)…
Colorectal cancer (CRC) is the third leading cause of cancer-related mortality worldwide. CRC spreads via two main mechanisms: cancer cells can metastasize to regional lymph nodes and then through central lymphatics into the systemic circulation, or cancer cells can spread…
Overview Hepatocellular carcinoma (HCC) is the most common primary liver tumor and results in approximately 800,000 deaths globally per year. Worldwide, liver tumors represent the fourth leading cause of cancer death and the sixth most common neoplasia. Its incidence presents…