Introduction Over the past decades, the management of colorectal liver metastases (CLM) has been transformed by several improvements in both medical and surgical fields (see Chapters 90 , 97 , 101 , and 102 ). The development of modern and…
Overview The liver is a unique organ with a rich dual blood supply (see Chapter 2 ) and serves as a target organ for many tumor metastases. As the portal vein drains the gastrointestinal (GI) tract, malignancies arising from these…
Cryotherapy Introduction Hepatic ablative techniques remain an important tool in the armamentarium against both primary and metastatic liver tumors. Liver resection continues to be the gold standard in management; however, ablative therapies are useful for patients with limited disease and…
Overview Each year nearly 1 million liver cancers are diagnosed across the world, making liver cancer the fifth most common cancer in men and ninth in women , (see Chapter 89 ). Liver cancer is one of the most fatal…
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…