Liver Metastases

What are liver metastases?

Liver metastases are cancerous lesions or tumors that have spread to the liver from a primary cancer elsewhere in the body. These tumors — sometimes called secondary liver cancer — are not really liver cancer at all. The cells of these liver metastases are not liver cells, but resemble the cancer cells of the primary tumor, such as neuroendocrine tumors (NETs), melanoma or cancers that began in the lung or breast. Because the liver receives all the blood return from the organs within the abdomen, it is a common site for metastatic disease from cancers originating in the gastrointestinal tract, such as the stomach, pancreas, bile duct and colon.

Patients with liver metastases can still be cured of their disease. Successful treatment demands specialized skills by surgeons with advanced training and focus in liver surgery and experienced medical oncology and interventional radiology teams working together. At Roswell Park, we do this every day.

Surgery for liver metastases

Determining whether your liver metastases are resectable — can be completely removed by surgery — is a key factor in how they will be treated. The ability to remove all the cancer can extend survival and potentially result in a cure. Treatment for colorectal liver metastases in particular can significantly impact survival because metastatic colorectal cancer tends to grow slowly enough and often remains confined to the liver. In this setting, chemotherapy is an important adjunct therapy that can enhance the results of operations for liver metastases. Learn more about Roswell Park’s options for colorectal metastases.

Our skilled hepatic surgeons perform a high volume of procedures to remove metastatic lesions and tumors in a way that spares as much liver as possible. We also incorporate techniques such as portal vein embolization prior to surgery, which causes the healthy part of the liver to grow larger, allowing for a safer liver surgery to remove the tumors.

Liver-directed therapies

Roswell Park offers many liver-directed therapies that treat liver tumors, regardless of their original site. These highly specialized treatments require advanced technology and multidisciplinary liver expertise from interventional radiologists and surgical and medical and oncologists working together. These treatments provide a surgical alternative for patients whose liver metastases are truly unresectable, or they can be delivered in addition to surgery. These include:

• Ablation procedures such as microwave ablation or radiofrequency ablation use a small probe inserted into the tumor. The probe emits microwaves or radio waves that heat the tissue, killing cancer cells. Ablation procedures can treat multiple sites and can be used in conjunction with surgery, or in cases in which surgery is not an option. These are minimally invasive techniques, frequently performed as outpatient procedures.
• Radioembolization (also called Selective Internal Radiation Therapy) places tiny radioactive spheres or beads (using the isotope yttrium-90) into the artery that supplies blood to the liver tumor. The beads both block (embolize) the blood flow to the tumors and deliver radiation directly into them. Radioembolization is an effective option for patients whose liver metastases are inoperable.
• Chemoembolization uses tiny beads containing anti-cancer drugs to block (embolize) blood flow to the liver tumor and deliver the drugs to the tumor.
• Hepatic artery infusion uses a small wireless pump about the size of a hockey puck that is surgically placed inside the abdominal wall, and a small tube (catheter) is inserted into the blood vessel that connects to the hepatic artery, the major blood vessel that carries blood to the liver. The pump allows doctors to continuously deliver a powerful dose of chemotherapy straight to the liver and provide a liver-directed treatment option for patients with high-risk liver tumors who could not undergo surgery.
• Stereotactic Body Radiation Therapy (SBRT) is a type of radiotherapy than can be used to target liver metastases.