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04 February 2021

İsmail Sert

General Surgery Specialist

Liver Metastases

Liver Metastases

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  • What is liver metastases?
  • Metastases is the spread of cancer from any organ in the body to another organ. The occurrence of this condition in the liver is called liver metastasis.
  • The liver is a large organ that filters blood. For this reason, cancer cells involved in the bloodstream get stuck in this organ and continue to grow. Especially since the blood coming from the digestive system (intestines) first passes through the liver, liver metastases of the cancers are common in this region. Cancer, which occurs in organs such as the large intestine, stomach, pancreas, bile ducts, and small intestine, frequently metastases to the liver. In addition to these, metastases of breast and lung cancer and lymphoma are also common.

 

  • How is the diagnosis made?
  • If metastases in the liver is widespread, it is easier to diagnose. The liver is enlarged and painful on examination. Also, laboratory tests like alkaline phosphatase and transaminase as the enzyme are observed in higher values. Imaging methods is the main diagnostic method of liver metastases. The presence of masses is revealed with imaging methods. If the initial point of cancer is known, it is easier to diagnose metastasis. However, if the source is unknown, it is difficult to distinguish these masses in the liver from primary liver cancer. For this, it may be necessary to take the most biopsy of the masses in the liver.

 

  • How is it treated?
  • Treatment planning in liver metastases; which stemmed from the spread of that organ, the prevalence levels, the spread of the liver settlement varies according to the weather and instead is spread to another organ. Especially those caused by lymph node can be treated with some chemotherapy. Those caused by breast and lung cancers also benefit partially from emotions.
  • In the treatment of liver metastases, it is necessary to separate colorectal (large intestine) cancer metastases. Colorectal cancers frequently metastasize to the liver, and surgical removal of the spread is very important for treatment.
  • How is the treatment performed in liver metastases of colorectal (large intestine) cancers?
  • Large intestine cancers are very common type of cancer. And metastases are found in the liver in about one-third of these patients during the diagnosis. In the other third, liver metastasis occurs during the follow-up of the disease. The presence of liver metastasis is the most important factor limiting the life period of these patients.
  • Surgical removal of colorectal cancer metastases in the liver is an important treatment method that significantly prolongs the life chances in these patients. However, it is not possible to remove surgically all liver metastases. The number, and location of metastasis, along with its distribution in the liver, its diameter, whether it can be removed with a safe margin, and the presence of a disease other than the liver are very important in while taking a decision for surgical intervention.
  • While life expectancy in non-surgical liver metastases is quite limited (five-year survival is approximately 10%). Long-term survival (five-year survival 40-50%) is possible in patients with proper removal of liver metastases. In some cases, liver recurrence (recurrence of the disease) may occur after a surgical treatment.  In order to prevent this risk, chemotherapy should be applied together with the surgery. When detected, metastasis which cannot be surgically removed can be reduced and drawn into surgical ranges with appropriate chemotherapy drugs. In some suitable cases, other auxiliary methods such as partially surgery and partially radiofrequency ablation can be used. In cases where surgery cannot be performed, the only method is chemotherapy. Chemotherapy can be applied systemically or it can be applied only to the liver. In this case, the surgeon, oncologist and patient should make the decision together.

 

  • Can surgery be applied in other cancer metastases?
  • Nowadays, only surgical treatment of liver metastases belonging to colorectal cancer can be mentioned as a standard. However, in very appropriate and well-selected cases, it is possible to successfully remove liver metastasis from breast, stomach, some pancreatic tumors, some tumors that secrete hormones, some tumors originating from testicles and ovaries and some kidney tumors, and to extend the expected life span in accordance with the oncology opinion.
  • Surgical removal of liver metastases can be made within the framework of all kinds of oncological based thinking for the treatment of colorectal cancer patients, which makes a significant difference in life span. Some of these approaches are as follows:
  • - Simultaneous colon and metastases surgery.
  • - Pre-operative chemotherapy and post-operative Metastases surgery application.
  • - Metastases surgery after liver volume expanding procedures with interventional radiology support in multiple or large metastasis.
  • - Simultaneous surgical removal of metastases and radiofrequency ablation applications in eligible patients.

 

  • Close follow-up with telemedicine
  • We strictly follow up our patients who have undergone liver surgery after been discharged. After discharge, we communicate with our patients visually and audibly through the telemedicine service, and if any abnormal complaints or findings are detected, without waiting for the appointment date we directly invite them to our hospital for a control, and for further examination and treatment.

 

 

Assoc. Prof. Dr. İsmail SERT

General Surgery