Benign and Malignant Tumors of the Liver

  • Anita Kit Wan Chiu
  • Yuman Fong


A decade ago, one eighth of the population of the United States was over the age of 65, and this small portion suffered one half of all cancers diagnosed [1]. It is projected by the U.S. Census Bureau that by the year 2030, more than 20% of the U.S. population will be over the age of 65. This demographic change alone will increase the number of cancers in America by approximately 30% [2, 3], making no other single factor as important as age for cancer incidence.


Liver Resection Cirrhotic Patient Liver Regeneration Metastatic Colorectal Cancer Primary Liver Cancer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Killen DA (1988) Cardiac surgery in the elderly. In: Adkins RB Jr, Scott HW Jr (eds) Surgical care for the elderly. Williams and Wilkins, Baltimore, pp 203–220Google Scholar
  2. 2.
    Koruda MJ, Sheldon GF (1992) Surgery in the aged. Curr Surg 293–331Google Scholar
  3. 3.
    Greenfield LJ (1975) Surgery of the aged. W.B. Saunders, PhiladelphiaGoogle Scholar
  4. 4.
    Brooks B (1937) Surgery in patients of advanced age. Ann Surg 105:481–501PubMedCrossRefGoogle Scholar
  5. 5.
    Fong Y, Blumgart LH, Fortner JG, Brennan MF (1995) Pancreatic or liver resection for malignancy is safe and effective for the elderly. Ann Surg 222(4):426–434PubMedGoogle Scholar
  6. 6.
    Menon KV, Al-Mukhtar A, Aldouri A, Prasad RK, Lodge PA, Toogood GJ (2006) Outcomes after major hepatectomy in elderly patients. J Am Coll Surg 203(5):677–683PubMedCrossRefGoogle Scholar
  7. 7.
    Kemeny MM (2004) Surgery in older patients. Semin Oncol 31(2):175–184PubMedCrossRefGoogle Scholar
  8. 8.
    Turrentine FE, Wang H, Simpson VB, Jones RS (2006) Surgical risk factors, morbidity, and mortality in elderly patients. J Am Coll Surg 203(6):865–877PubMedCrossRefGoogle Scholar
  9. 9.
    Finlayson E, Fan Z, Birkmeyer JD (2007) Outcomes in octogenarians undergoing high-risk cancer operation: a national study. J Am Coll Surg 205(6):729–734PubMedCrossRefGoogle Scholar
  10. 10.
    Parker SL, Tong T, Bolden S, Wingo PA (1996) Cancer statistics, 1996. CA Cancer J Clin 46(1):5–27PubMedCrossRefGoogle Scholar
  11. 11.
    Fortner JG, Silva JS, Cox EB, Golbey RB, Gallowitz H, Maclean BJ (1984) Multivariate-analysis of a personal series of 247 patients with liver metastases from colorectal-cancer. 2. Treatment by intrahepatic chemotherapy. Ann Surg 199(3):317–324PubMedCrossRefGoogle Scholar
  12. 12.
    Rosen CB, Nagorney DM, Taswell HF, Helgeson SL, Ilstrup DM, Van Heerden JA et al (1992) Perioperative blood transfusion and determinants of survival after liver resection for metastatic colorectal carcinoma. Ann Surg 216:492–505CrossRefGoogle Scholar
  13. 13.
    Gayowski TJ, Iwatsuki S, Madariaga JR, Selby R, Todo S, Irish W et al (1994) Experience in hepatic resection for metastatic colorectal cancer: analysis of clinical and pathologic risk factors. Surgery 116:703–711PubMedGoogle Scholar
  14. 14.
    de Liguori CN, van Leeuwen BL, Ghaneh P, Wu A, Audisio RA, Poston GJ (2008) Liver resection for colorectal liver metastases in older patients. Crit Rev Oncol Hematol 67(3):273–278CrossRefGoogle Scholar
  15. 15.
    Ezaki T, Yukaya H, Ogawa Y (1987) Evaluation of hepatic resection for hepatocellular carcinoma in the elderly. Br J Surg 74:471–473PubMedCrossRefGoogle Scholar
  16. 16.
    Yanaga K, Kanematsu T, Takenaka K, Matsumata T, Yoshida Y, Sugimachi K (1988) Hepatic resection for hepatocellular carcinoma in elderly patients. Am J Surg 155:238–241PubMedCrossRefGoogle Scholar
  17. 17.
    Fortner JG, Lincer RM (1990) Hepatic resection in the elderly. Ann Surg 211:141–145PubMedCrossRefGoogle Scholar
  18. 18.
    Fong Y, Blumgart LH, Cohen A, Fortner J, Brennan MF (1994) Repeat hepatic resections for metastatic colorectal cancer. Ann Surg 220(5):657–662PubMedCrossRefGoogle Scholar
  19. 19.
    Virani S, Michaelson JS, Hutter MM, Lancaster RT, Warshaw AL, Henderson WG et al (2007) Morbidity and mortality after liver resection: results of the patient safety in surgery study. J Am Coll Surg 204(6):1284–1292PubMedCrossRefGoogle Scholar
  20. 20.
    Nagasue N, Chang YC, Takemoto Y, Taniura H, Kohno H, Nakamura T (1993) Liver resection in the aged (seventy years or older) with hepatocellular carcinoma. Surgery 113:148–154PubMedGoogle Scholar
  21. 21.
    Takenaka K, Shimada M, Higashi H, Adachi E, Nishizaki T, Yanaga K et al (1994) Liver resection for hepatocellular carcinoma in the elderly. Arch Surg 131:71–76CrossRefGoogle Scholar
  22. 22.
    Schwartz SI (1981) Biliary tract surgery and cirrhosis: a critical combination. Surgery 90:577–583PubMedGoogle Scholar
  23. 23.
    Mentha G, Huber O, Robert J, Klopfenstein C, Egeli R, Rohner A (1992) Elective hepatic resection in the elderly. Br J Surg 79:557–559PubMedCrossRefGoogle Scholar
  24. 24.
    Karl RC, Smith SK, Fabri PJ (1995) Validity of major cancer operations in elderly patients. Ann Surg Oncol 2:107–113PubMedCrossRefGoogle Scholar
  25. 25.
    Fong Y, Brennan MF, Cohen AM, Heffernan N, Freiman A, Blumgart LH (1997) Liver resection in the elderly. Br J Surg 84(10):1386–1390PubMedCrossRefGoogle Scholar
  26. 26.
    Aldrighetti L, Arru M, Catena M, Finazzi R, Ferla G (2006) Liver resections in over-75-year-old patients: surgical hazard or current practice? J Surg Oncol 93(3):186–193PubMedCrossRefGoogle Scholar
  27. 27.
    Mann CD, Neal CP, Pattenden CJ, Metcalfe MS, Garcea G, Dennison AR et al (2008) Major resection of hepatic colorectal liver metastases in elderly patients – an aggressive approach is justified. Eur J Surg Oncol 34(4):428–432PubMedCrossRefGoogle Scholar
  28. 28.
    Wynne HA, Cope LH, Mutch E, Rawlins MD, Woodhouse KW, James OFW (1989) The effect of age upon liver volume and apparent blood flow in healthy man. Hepatology 9:297–301PubMedCrossRefGoogle Scholar
  29. 29.
    Asano K, Nakamura M, Asano A, Sato T, Tauchi H (1992) Quantitation of changes in mitochondrial DNA during aging and regeneration of rat liver using non-radioactive DNA probes. Mech Ageing Dev 62:85–98CrossRefGoogle Scholar
  30. 30.
    Mooney H, Roberts R, Cooksley WGE, Halliday JW, Powell LW (1985) Alterations in the liver with ageing. Clin Gastroenterol 14:757–771PubMedGoogle Scholar
  31. 31.
    Yamamoto K, Takenaka K, Matsumata T, Shimada M, Itsaka H, Shirabe K et al (1997) Right hepatic lobectomy in elderly patients with hepatocellular carcinoma. Hepatogastroenterology 44:514–518PubMedGoogle Scholar
  32. 32.
    Carrillo MC, Carnovale CE, Favre C, Monti JA, Scapini C (1996) Hepatic protein synthesis and serum aminoacid levels during liver regeneration in young and old malnourished rats. Mech Ageing Dev 91:55–64PubMedCrossRefGoogle Scholar
  33. 33.
    Schapiro H, Hotta SS, Outten WE, Klein AW (1982) The effect of aging on rat liver regeneration. Experientia 38:1075–1076PubMedCrossRefGoogle Scholar
  34. 34.
    Beyer HS, Sherman R, Zieve L (1991) Aging is associated with reduced liver regeneration and diminished thymidine kinase mRNA content and enzyme activity in the rat. J Lab Clin Med 117:101–108PubMedGoogle Scholar
  35. 35.
    Fry M, Silber J, Loeb LA, Martin GM (1984) Delayed and reduced cell replication and diminishing levels of DNA polymerase-alpha in regenerating liver of aging mice. J Cell Physiol 118:225–232PubMedCrossRefGoogle Scholar
  36. 36.
    Taguchi T, Ohashi M (1996) Age-associated changes in the template-reading fidelity of DNA polymerase alpha from regenerating rat liver. Mech Ageing Dev 92:143–157PubMedCrossRefGoogle Scholar
  37. 37.
    Piantanelli L, Ermini M, Ricciotti R (1974) Histone phosphorylation after partial hepatectomy in young and old rats. Experientia 30(2):210–211Google Scholar
  38. 38.
    Oh YH, Conard RA (1972) Effect of aging on histone acetylation of the normal and regenerating rat liver. Life Sci 11(2):1207–1214CrossRefGoogle Scholar
  39. 39.
    Ferrucci JT (1991) Liver tumor imaging. Cancer 67:1189–1195PubMedCrossRefGoogle Scholar
  40. 40.
    Larson RE, Semelka RC (1995) Magnetic resonance imaging of the liver. Top Magn Reson Imaging 7(2):71–81PubMedCrossRefGoogle Scholar
  41. 41.
    Nichols FC, Van Heerden JA, Weiland LA (1989) Benign liver tumors. Surg Clin North Am 69:290–313Google Scholar
  42. 42.
    Leese T, Farges O, Bismuth H (1988) Liver cell adenomas: a 12 year surgical experience from a specialist hepatobiliary unit. Ann Surg 208:558–564PubMedCrossRefGoogle Scholar
  43. 43.
    Schwartz SI, Husser WC (1987) Cavernous hemangioma of the liver. Ann Surg 205:456PubMedCrossRefGoogle Scholar
  44. 44.
    Kuo PC, Lewis WD, Jenkins RL (1994) Treatment of giant hemangiomas of the liver by enucleation. J Am Coll Surg 178:49PubMedGoogle Scholar
  45. 45.
    Trastek VF, Van Heerden JA, Sheedy PFI, Adson MA (1983) Cavernous hemangiomas of the liver: resect or observe? Am J Surg 145:49PubMedCrossRefGoogle Scholar
  46. 46.
    Yamagata M, Kanematsu T, Matsumata T, Utsunomiya T, Ikeda Y, Sugimachi K (1991) Management of hemangioma of the liver: comparison between surgery and observation. Br J Surg 78:1223PubMedCrossRefGoogle Scholar
  47. 47.
    Gaspar L, Mascarenhas F, de Costa MS, Dias JS, Afonso JG, Silvestre ME (1993) Radiation therapy in the unresectable cavernous hemangioma of the liver. Radiother Oncol 29:45–50PubMedCrossRefGoogle Scholar
  48. 48.
    Biswal BM, Sandhu M, Lal P, Bal CS (1995) Role of radiotherapy in cavernous hemangioma of liver. Indian J Gastroenterol 14:95–98PubMedGoogle Scholar
  49. 49.
    Yamamoto T, Kawarda Y, Yano T, Noguichi T, Mizumoto R (1991) Spontaneous rupture of hemangioma of the liver: treatment with transcatheter hepatic arterial embolization. Am J Gastroenterol 86:1645–1649PubMedGoogle Scholar
  50. 50.
    RJSr McKenna, Murphy GP (1994) Cancer surgery. J.B. Lipincott, PhiladelphiaGoogle Scholar
  51. 51.
    Farmer DG, Rosove MH, Shaked A, Busuttil RW (1994) Treatment of hepatocellular carcinoma. Ann Surg 219:236–247PubMedCrossRefGoogle Scholar
  52. 52.
    Takayasu K, Moriyama N, Muramatsu Y, Makuuchi M, Hasegawa H, Okazaki N et al (1990) The diagnosis of small carcinomas: efficacy of various imaging procedures in 100 patients. Am J Radiol 155:49–54Google Scholar
  53. 53.
    Blumgart LH (1988) Liver resection-liver and biliary tumours. In: Blumgart LH (ed) Surgery of the liver and biliary tract, 1st edn. Churchill Livingstone, New York, pp 1251–1280Google Scholar
  54. 54.
    Parker GA, Lawrence W Jr, Horsley JS III, Neifeld JP, Cook D, Walsh J et al (1989) Intraoperative ultrasound of the liver affects operative decision making. Ann Surg 209:569–577PubMedCrossRefGoogle Scholar
  55. 55.
    Iwatsuki S, Starzl TE (1988) Personal experience with 411 hepatic resections. Ann Surg 4:421–434CrossRefGoogle Scholar
  56. 56.
    Fong Y, Blumgart LH (1996) Surgical therapy of liver cancer. In: Zakim D, Boyer TD (eds) Hepatology, 3rd edn. W.B.Saunders, Philadelphia, pp 1548–1564Google Scholar
  57. 57.
    Iwatsuki S, Gordon RD, BWJr S, Starzl TE (1985) Role of liver transplantation in cancer therapy. Ann Surg 202:401–407PubMedCrossRefGoogle Scholar
  58. 58.
    Bismuth H, Morino M, Sherlock D, Castaing D, Miglietta C, Cauquil P et al (1992) Primary treatment of hepatocellular carcinoma by arterial chemoembolization. Am J Surg 163:387–394PubMedCrossRefGoogle Scholar
  59. 59.
    Raoul JL, Heresbach D, Bretagne JF, Bentue Ferrer D, Duvauferrier R, Bourguet P et al (1992) Chemoembolization of hepatocellular carcinomas. Cancer 70:585–589PubMedCrossRefGoogle Scholar
  60. 60.
    Brown K, Nevins AB, Getradjman G, Brody LA, Kurtz RC, Fong Y et al (1998) Particle embolization of hepatocellular carcinoma. J Vasc Interv Radiol 9(5):822–828PubMedCrossRefGoogle Scholar
  61. 61.
    Livraghi T, Solbiati L, Meloni MF, Gazelle GS, Halpern EF, Goldberg SN (2003) Treatment of focal liver tumors with percutaneous radio-frequency ablation: complications encountered in a multicenter study. Radiology 226(2):441–451PubMedCrossRefGoogle Scholar
  62. 62.
    Livraghi T, Bolondi L, Lazzaroni S, Marin G, Morabito A, Rapaccini GL et al (1992) Percutaneous ethanol injection in the treatment of hepatocellular carcinoma in cirrhosis. A study on 207 patients. Cancer 69:925–929PubMedCrossRefGoogle Scholar
  63. 63.
    Sitzman JV, Abrams R (1993) Improved survival for hepatocellular cancer with combination surgery and multimodal treatment. Ann Surg 217:149–154CrossRefGoogle Scholar
  64. 64.
    Liang HH, Chen MS, Peng ZW, Zhang YJ, Zhang YQ, Li JQ et al (2008) Percutaneous radiofrequency ablation versus repeat hepatectomy for recurrent hepatocellular carcinoma: a retrospective study. Ann Surg Oncol 15(12):3484–3493PubMedCrossRefGoogle Scholar
  65. 65.
    Hughes KS, Simon R, Songhorabodi S, Adson MA, Ilstrup DM, Fortner JG et al (1986) Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of patterns of recurrence. Surgery 100:278–284PubMedGoogle Scholar
  66. 66.
    Wood CB, Gillis CR, Blumgart LH (1976) A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Oncol 2:285–288PubMedGoogle Scholar
  67. 67.
    Doroshow JH, Multhauf P, Leong L, Margolin K, Litchfield T, Akman S et al (1990) Prospective randomized comparison of fluorouracil versus fluorouracil and high-dose continuous infusion leucovorin calcium for the treatment of advanced measurable colorectal cancer in patients previously unexposed to chemotherapy. J Clin Oncol 8:491–501PubMedGoogle Scholar
  68. 68.
    Colucci G, Maiello E, Giuliani F, Serraveza G, Pezzella G, Leo S et al (1994) Biochemical modulation of 5-fluorouracil (FU) and liver metastases of colorectal cancer patients. Ann Oncol 5(8):53Google Scholar
  69. 69.
    Kunimoto T, Nitta K, Tanaka T, Uehara N, Baba H, Takeuchi M et al (1987) Antitumor activity of 7-ethyl-10-[4-(1-piperidino)-1-­piperidino]carbonyloxy-camptothecin, a novel water-soluble derivative of camptothecin, against murine tumors. Cancer Res 47:5944–5947PubMedGoogle Scholar
  70. 70.
    Tsuruo T, Matsuzaki T, Matsushita M, Saito H, Yokokura T (1988) Antitumor effect of CPT-11, a new derivative of camptothecin, against pleiotropic drug-resistant tumors in vitro and in vivo. Cancer Chemother Pharmacol 21:71–74PubMedCrossRefGoogle Scholar
  71. 71.
    Scheele J, Stang R, Altendorf-Hofmann A, Paul M (1995) Resection of colorectal liver metastases. World J Surg 19:59–71PubMedCrossRefGoogle Scholar
  72. 72.
    van de Velde CJH, Sugarbaker PH (1984) Liver metastases. Martinus Nijhoff, AmsterdamCrossRefGoogle Scholar
  73. 73.
    Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15(3):938–946PubMedGoogle Scholar
  74. 74.
    Schlag P, Hohenberger P, Herfarth Ch (1990) Resection of liver metastases in colorectal cancer – competitive analysis of treatment results in synchronous versus metachronous metastases. Eur J Surg Oncol 16:360–365PubMedGoogle Scholar
  75. 75.
    Haberkorn U, Bellemann ME, Altmann A, Gerlach L, Morr I, Oberdorfer F et al (1997) PET 2-fluoro-2-deoxyglucose uptake in rat prostate adenocarcinoma during chemotherapy with gemcitabine. J Nucl Med 38(8):1215–1221PubMedGoogle Scholar
  76. 76.
    Hughes KS, Simons R, Songhorabodi S, Adson MA et al (1988) Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Surgery 103:278–288Google Scholar
  77. 77.
    Doci R, Gennari L, Bignami P, Montalto F, Morabita A, Bozzetti F (1991) One hundred patients with hepatic metastases from colorectal cancer treated by resection: analysis of prognostic determinants. Br J Surg 78:797–801PubMedCrossRefGoogle Scholar
  78. 78.
    Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP (1991) Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 110:13–29PubMedGoogle Scholar
  79. 79.
    Ekberg H, Tranberg KG, Andersson R, Lundstedt C, Hagerstrand I, Ranstam J et al (1987) Pattern of recurrence in liver resection for colorectal secondaries. World J Surg 11(4):541–547PubMedCrossRefGoogle Scholar
  80. 80.
    Cunningham JD, Fong Y, Shriver C, Melendez J, Marx WL, Blumgart LH (1994) One hundred consecutive hepatic resections. Blood loss, transfusion, and operative technique. Arch Surg 129(10):1050–1056PubMedCrossRefGoogle Scholar
  81. 81.
    Jamison RL, Donohue JH, Nagorney DM, Rosen CB, Harmsen WS, Ilstrup DM (1997) Hepatic resection for metastatic colorectal cancer results in cure for some patients. Arch Surg 132:505–511PubMedCrossRefGoogle Scholar
  82. 82.
    Nguyen KT, Gamblin TC, Geller DA (2008) Laparoscopic liver resection for cancer. Future Oncol 4(5):661–670PubMedCrossRefGoogle Scholar
  83. 83.
    Buell JF, Thomas MT, Rudich S, Marvin M, Nagubandi R, Ravindra KV et al (2008) Experience with more than 500 minimally invasive hepatic procedures. Ann Surg 248(3):475–486PubMedGoogle Scholar
  84. 84.
    Laurence JM, Lam VW, Langcake ME, Hollands MJ, Crawford MD, Pleass HC (2007) Laparoscopic hepatectomy, a systematic review. ANZ J Surg 77(11):948–953PubMedCrossRefGoogle Scholar
  85. 85.
    Santambrogio R, Aldrighetti L, Barabino M, Pulitano C, Costa M, Montorsi M et al (2009) Laparoscopic liver resections for hepatocellular carcinoma. Is it a feasible option for patients with liver cirrhosis? Langenbecks Arch Surg 394(2):255–264PubMedCrossRefGoogle Scholar
  86. 86.
    Zacharias T, Jaeck D, Oussoultzoglou E, Bachellier P, Weber JC (2004) First and repeat resection of colorectal liver metastases in elderly patients. Ann Surg 240(5):858–865PubMedCrossRefGoogle Scholar
  87. 87.
    Nagano Y, Nojiri K, Matsuo K, Tanaka K, Togo S, Ike H et al (2005) The impact of advanced age on hepatic resection of colorectal liver metastases. J Am Coll Surg 201(4):511–516PubMedCrossRefGoogle Scholar
  88. 88.
    Brand MI, Saclarides TJ, Dobson HD, Millikan KW (2000) Liver resection for colorectal cancer: liver metastases in the aged. Am Surg 66(4):412–415PubMedGoogle Scholar
  89. 89.
    Figueras J, Ramos E, Lopez-Ben S, Torras J, Albiol M, Llado L et al (2007) Surgical treatment of liver metastases from colorectal carcinoma in elderly patients. When is it worthwhile? Clin Transl Oncol 9(6):392–400PubMedCrossRefGoogle Scholar
  90. 90.
    Riffat F, Chu F, Morris DL (2006) Liver resection in octogenarians. HPB (Oxford) 8(3):206–210CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Anita Kit Wan Chiu
  • Yuman Fong
    • 1
  1. 1.Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA

Personalised recommendations