Management of Colorectal Cancer Liver Metastasis

Hwang, Dae Yong

Abstract

The liver is the predominant metastatic site of colorectal cancer. When the patients general condition, the absence of extrahepatic metastases, number and locations of hepatic lesions permit, hepatic resection may be curative and should be considered standard therapy. Regional approaches, such as cryotherapy, alcohol injection, radiation therapy, interstitial laser therapy, and chemoembolization even that may bring about effective palliation suggest experimental approaches to the treatment of hepatic metastases. Regional infusion of chemotherapeutic agent via hepatic artery has shown a great tumor response, but further studies are needed for evaluation of precise benefit of this approach. Manipulation of the gene level was recently possible and addressed for the treatment of unresectable hepatic metastases, but still many problems to overcome are remained for the effective delivery and selective expression of the therapeutic gene or gene product to the target cells. Thus, new approaches to the colorectal cancer liver metastases are clearly warranted.