Hepatic Metastases from Gastrointestinal Malignancies and Hepatocellular Carcinoma

Abstract

The liver is the primary site of distant metastases of colorectal carcinoma and as such becomes of significant concern to the oncologist in not only advanced local disease but also the planning of early stage adjuvant therapy. Welch and Donaldson (1979), through a study of autopsy series, estimated that more than 80% of patients with metastatic colorectal cancer had tumor involvement of the liver. It was also estimated that in more than half of those dying of metastatic disease, the liver was the only site of involvement with the disease. This finding prompted the surgical resection of solitary metastases which yielded a relatively high 5-year survival rate of up to 33% (Adson et al. 1984; Cady and McDermott 1985). Untreated patients, however, have a poor prognosis. Jaffe et al. (1968) studied the natural history of 390 patients with untreated liver metastases and estimated that the median survival of such patients was only 75 days. Later, Woods et al. (1976) also showed a poor survival of 6–20 weeks for patients with liver metastases secondary to colorectal cancer if the liver remains untreated.