The Natural History of Metastases to the Liver

  • Mark J. Lieser
  • David M. Nagorney


The liver is the repository of metastatic deposits from virtually any primary tumour site and type. Although most discussions of hepatic metastases focus on those of colorectal origin because of their higher incidence of liver metastases, primaries including sarcomas, breast, kidney and neuroendocrine tumours also metastasize to the liver. According to Tumour, Node, Metastisis classification, tumour deposits in the liver by definition denote distant disease. Thus, the presence of hepatic metastases always indicates a worsening of prognosis, and a significant decrease in the likelihood of cure.


Colorectal Cancer Liver Metastasis Colorectal Carcinoma Hepatic Resection Neuroendocrine Tumour 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Parker SL, Tong T, Bolden S, Wingo PA. Cancer statistics,1996. CA Cancer J Clin 1996; 46:5–27.CrossRefGoogle Scholar
  2. 2.
    Levitan N, Hughes KS. Management of non-resectable liver metastases from colorectal cancer. Oncology 1990; 4:77–84.PubMedGoogle Scholar
  3. 3.
    Kune GA, Kune S, Field B et al. Survival in patients with large bowel cancer. A population-based investigation from the Melbourne Colorectal Cancer Study. Dis Colon Rectum1990; 33:938–946.Google Scholar
  4. 4.
    Turnbull RB, Jr., Kyle K, Watson FR, Spratt J. Cancer of the colon: The influence of the no touch isolation technique on survival rates. Ann Surg 1967; 166:420–427.PubMedCrossRefGoogle Scholar
  5. 5.
    Finlay IG, McArdle CS. Occult hepatic metastases in colorectal carcinoma. BrJ Surg 1986; 73:732–735.PubMedCrossRefGoogle Scholar
  6. 6.
    Machi J, Isomoto H, Kurohiji Tet al. Accuracy of intraoperative ultrasonography in diagnosing liver metastases from colorectal cancer: Evaluation with postoperative follow-up results. World J Surg 1991; 15:551–557.PubMedCrossRefGoogle Scholar
  7. 7.
    Olsen AK. Intraoperative ultrasonography and the detection of liver metastases at laparotomy. Aust NZ J Surg 1980; 50:524–526.CrossRefGoogle Scholar
  8. 8.
    Stadler J, Holscher AH, Adolf J. Intraoperative ultrasonographic detection of occult liver metastases in colorectal cancer. Surg Endosc 1991; 5:36–40.PubMedCrossRefGoogle Scholar
  9. 9.
    Goligher JC. The operability of carcinoma of the rectum. BMJ 1941; 393–397.Google Scholar
  10. 10.
    Hogg L, Pack GK. Diagnostic accuracy of hepatic metastases at laparotomy. Arch Surg 1956; 72:251–252.Google Scholar
  11. 11.
    Gray BN. Surgeon accuracy in the diagnosis of liver metastases at laparotomy. Aust NZ J Surg 1980; 50:524–526.CrossRefGoogle Scholar
  12. 12.
    Faivre J, Rat P, Arveux P. Epidemiology of liver metastases from colorectal cancer. In: Nordlinger B, Jaeck D (eds)Treatment of Hepatic Metastases of Colorectal Cancer 1992:33–8. Paris: Springer Verlag.Google Scholar
  13. 13.
    Gompertz B. On the nature of the function expressive of the law of human mortality and on the new mode of determining the value oflife contingencies. Phil Trans R Soc London 1825 115:5l3–585Google Scholar
  14. 14.
    Norton L, Simon R. Growth curve of an experimental solid tumor following radiotherapy. JNatl Cancer Inst 1977; 58:1735–1741.Google Scholar
  15. 15.
    Finlay IG, Meek D, Brunton F, McArdle CS. Growth rates of hepatic metastases in colorectal carcinoma. Br J Surg 1988; 75:641–644.PubMedCrossRefGoogle Scholar
  16. 16.
    Baserga R. The cell cycle. NE JM 1981; 304:453–459.PubMedCrossRefGoogle Scholar
  17. 17.
    Retsky MW, Swartzendruber DE, Bame PD, Wardwell RH. Computer model challenges breast cancer treatment strategy. Cancer Invest 1994; 12:559–567.PubMedCrossRefGoogle Scholar
  18. 18.
    Radinsky R, Ellis LM. Molecular determinants in the biology ofliver metastases. Surg Oncol Clin NA 1996; 5:215–230.Google Scholar
  19. 19.
    Loizidou MC, Lawrence RJ, Holt Set al. Facilitation by partial hepatectomy of tumor growth within the rat liver following the intraportal injection of syngeneic tumor cells. Clin Exp Metastasis 1991; 9:335–349.PubMedCrossRefGoogle Scholar
  20. 20.
    Michalopoulos GK. Liver regeneration: Molecular mechanisms of growth control. FASEB J 1990; 4:176–187.PubMedGoogle Scholar
  21. 21.
    Levy A, Cioce V, Sobel MEet al. Increased expression of the 72 kDa type IV collagenase in human colonic adenocarcinoma. Cancer Res 1991; 51:439–444.PubMedGoogle Scholar
  22. 22.
    Coulombe J, Pelletier G. Gangliosides and organ-specific metastatic colonization. Int J Cancer 1993; 53:104–109.PubMedCrossRefGoogle Scholar
  23. 23.
    Fujita S, Suzuki J, Kinoshita Met al. Inhibition of cell attachment, invasion and metastasis of human carcinoma cells by anti-integrin beta-l subunit antibody. Jpn J Cancer Res 1992; 83:1317–1326.Google Scholar
  24. 24.
    Tanabe KK, Ellis LM, Saya H. Expression of the CD44Rl adhesion molecule is increased in human colon adenocarcinomas and metastases. Lancet 1993; 341:725–726.PubMedCrossRefGoogle Scholar
  25. 25.
    Ellis LM, Liu W. Vascular endothelial growth factor (VEGF) expression and alternate splicing in non-metastatic and metastatic human colon cancer cell lines. Proc AACR1995; 36:A525.Google Scholar
  26. 26.
    Taylor I, Mullee MA, Campbell MJ. Prognostic index for the development of liver metastases in patients with colorectal cancer. Br J Surg 1990; 77:499–501.PubMedCrossRefGoogle Scholar
  27. 27.
    Morris MJ, Newland RC, Pheils MT, Macpherson JG. Hepatic metastases from colorectal carcinoma: an analysis of survival rates and histopathology. Aust NZJ Surg 1977; 47:365–368.Google Scholar
  28. 28.
    Tsuchiya A, Ando Y, Kikuchi Y, Kanazawa Met al. Venous invasion as a prognostic factor in colorectal cancer. Surg Today 1995; 25:950–953.PubMedCrossRefGoogle Scholar
  29. 29.
    Pickren JW, Tsukada Y, Lane WW. Liver metastasis: Analysis of autopsy data. In: Weiss L, Gilbert HA, (eds)Liver Metastasis 1982; 222–28. Boston: Hall MedicalGoogle Scholar
  30. 30.
    Uetsuji S, Yamamura M, Yamamichi Ket al. Absence of colorectal cancer metastases to the cirrhotic liver. Am J Surg 1992; 164:176–177.PubMedCrossRefGoogle Scholar
  31. 31.
    Stearns MW, Brinkley GJ. Palliative surgery for cancer of the rectum and colon. Cancer 1954; 7:1016–1019.PubMedCrossRefGoogle Scholar
  32. 32.
    Bacon HE, Martin PV. The rationale of palliative resection for primary cancer of the colon complicated by liver and lung metastases. Dis Colon Rectum 1964; 7:211–217.PubMedCrossRefGoogle Scholar
  33. 33.
    Pestana C, Reitemeyer RJ, Moertel CGet al. The natural history of carcinoma of the colon and rectum. Am J Surg 1964; 108:826–829.PubMedCrossRefGoogle Scholar
  34. 34.
    Jaffe BM, Donegan WL, Watson Fet al. Factors influencing survival in patients with untreated hepatic metastases. Surg Gynecol Obstet 1968; 127:1–11.PubMedGoogle Scholar
  35. 35.
    Bengmark S, Hafstrom 1. The natural history of primary and secondary malignant tumors of the liver: 1. The prognosis for patients with hepatic metastases from colonic and rectal carcinoma at laparotomy. Cancer 1969; 23:198–202.PubMedCrossRefGoogle Scholar
  36. 36.
    Oxley EM, Ellis H. Prognosis of carcinoma of the large bowel in the presence of liver metastases. Br J Surg1969; 56:149–152.PubMedCrossRefGoogle Scholar
  37. 37.
    Cady B, Monson DO, Swinton NW. Survival of patients after colonic resection for carcinoma with simultaneous liver metastases. Surg Gynecol Obstet 1970; 131:697–700.PubMedGoogle Scholar
  38. 38.
    Abrams MS, Lerner HJ. Survival of patients at Pennsylvania Hospital with hepatic metastases from carcinoma of the colon and rectum. Dis Colon Rectum 1971; 14:431–434.PubMedCrossRefGoogle Scholar
  39. 39.
    Nielson I, Barlslev I, Jensen HE. Carcinoma of the colon with liver metastases. Acta Chir Scand 1971; 137:463–465.Google Scholar
  40. 40.
    Baden H, Anderson B. Survival of patients with untreated liver metastases from colorectal cancer. Scand J Gastroenterol 1975; 10:221–223.PubMedGoogle Scholar
  41. 41.
    Wilson SM, Adson MA. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg 1976; 111:330–334.PubMedGoogle Scholar
  42. 42.
    Wood CB, Gillis CR, Blumgart LH. A retrospective study of the natural history of patients with liver metastases from colorectal cancer. Clin Onco11976; 2:285–288. Google Scholar
  43. 43.
    Wanebo HI, Semoglon C, Attiyeh Fet al. Surgical management of patients with primary operable colorectal cancer and synchronous liver metastases. Am J Surg 1978; 135:81–84.PubMedCrossRefGoogle Scholar
  44. 44.
    Bengston G, Carlsson G, Hafstrom Let al. Natural history of patients with untreated liver metastases from colorectal cancer. Am J Surg 1981; 141:586–589.CrossRefGoogle Scholar
  45. 45.
    Goslin R, Steele G, Zamcheck Net al. Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon and rectum. Dis Colon Rectum 1982; 25:749–754.PubMedCrossRefGoogle Scholar
  46. 46.
    Lahr CJ, Soong S-I, Cloud Get al. A multifactorial analysis of prognostic factors in patients with liver metastases from colorectal carcinoma. J Clin Oneal 1983; 1:720–726.Google Scholar
  47. 47.
    Wagner JS, Adson MA, van Heerden JAet al. The natural history of hepatic metastases from colorectal cancer: A comparison with resective treatment. Ann Surg 1984; 199:502–508.PubMedCrossRefGoogle Scholar
  48. 48.
    Finan PI, Marshall RI, Cooper EHet al. Factors affecting survival in patients presenting with synchronous hepatic metastases from colorectal cancer: A clinical and computer analysis. Br J Surg 1985; 72:373–377.PubMedCrossRefGoogle Scholar
  49. 49.
    DeBrauw LM, DeVelde CJH, Bouwhuis-Hoogerwerf M1. Diagnostic evaluation and survival analysis of colorectal cancer patients with liver metastases. J Surg Oneal 1989; 7: 1407–1418.Google Scholar
  50. 50.
    Palmer M, Petrelli NI, Herrera 1. No treatment option for liver metastases from colorectal adenocarcinoma. Dis Colon Rectum 1989; 32:698–701.PubMedCrossRefGoogle Scholar
  51. 51.
    Scheele J, Stangl R, Altendorf-Hofmann A. Hepatic metastases from colorectal carcinoma: Impact of surgical resection on the natural history. Br J Surg 1990; 77:1241–1246.PubMedCrossRefGoogle Scholar
  52. 52.
    Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J. Factors influencing the natural history of colorectal liver metastases. Lancet 1994; 343:1405–1410.PubMedCrossRefGoogle Scholar
  53. 53.
    Rougier P, Milan C, Lazorthes F,et al. Prospective study of prognostic factors in patients with unresected hepatic metastases from colorectal cancer. Br J Surg 1995; 82:1397–1400.PubMedCrossRefGoogle Scholar
  54. 54.
    Hughes KS, Rosenstein RB, Songhorabodi Set al. Resection of the liver for colorectal carcinoma metastases. Dis Colon Rectum 1988; 31:1–4.PubMedCrossRefGoogle Scholar
  55. 55.
    Kemeny MM, Hogan IN, Ganteaune L, Goldberg DA, Terz JJ. Preoperative staging with computerized axial tomography and biochemical tests in patients with hepatic metastases. Ann Surg 1986; 203:169–172.PubMedCrossRefGoogle Scholar
  56. 56.
    Ferrucci JT. Liver tumor imaging—current concepts. Radial Clin NA 1994; 32:39–54.Google Scholar
  57. 57.
    Soyer P, Bluenke DA, Hruban RHet al. Hepatic metastases from colorectal cancer: Detection and false positive findings with helical CT during arterial portography. Radiology1994; 193:71–74.PubMedGoogle Scholar
  58. 58.
    Thoeni RF. Clinical applications of magnetic resonance imaging of the liver. Invest Radial 1990; 26:266–273.CrossRefGoogle Scholar
  59. 59.
    Burak WE Jr., Schneebaum S, Kim JAet al. Pilot study evaluating the intraoperative localization of radiolabeled monoclonal antibody CC83 in patients with metastatic colorectal carcinoma. Surgery 1995; 118:103–108.PubMedCrossRefGoogle Scholar
  60. 60.
    Bertsch DI, Burak WE Jr., Young DCet al. Radioimmunoguided surgery system improves survival for patients with recurrent colorectal cancer. Surgery 1995; 118:634–639.PubMedCrossRefGoogle Scholar
  61. 61.
    Kemeny N, Brown DW. Prognostic factors in advanced colorectal carcinoma: the importance of lactic dehydrogenase, performance status and white blood cell count. Am J Med 1983; 74:786–794.PubMedCrossRefGoogle Scholar
  62. 62.
    Bedikian AY, Chen TT, Malaky MAet al. Prognostic factors influencing survival of patients with advanced colorectal cancer: Hepatic artery infusion versus systemic intravenous chemotherapy for liver metastases. J Clin Oncol 1984; 2:174–180.PubMedGoogle Scholar
  63. 63.
    Ekberg J, Tranberg KG, Lunstedt Cet al. Determinant of survival after intra-arterial infusion of 5-fluorouracil for liver metastases from colorectal cancer. A multivariate analysis. J Surg Onco11986; 31:246–254. Google Scholar
  64. 64.
    Chang AE, Steinberg SM, Culnane Met al. Determinants of survival in patients with unresectable colorectalliver metastases. J Surg Onco 11989; 40:245–251.Google Scholar
  65. 65.
    Kemeny N, Niedwiecki D, Shurgot Bet al. Prognostic variables in patients with hepatic metastases from colorectal cancer: Importance of medical assessment of liver involvement. Cancer 1989; 63:742–747.PubMedCrossRefGoogle Scholar
  66. 66.
    Fortner JG, Silva JS, Cox EBet al. Multivariate analysis of a personal series of247 patients with liver metastases from col orectal cancer. II. Treatment by intrahepatic chemotherapy. Ann Surg 1984;199:317–323.PubMedCrossRefGoogle Scholar
  67. 67.
    GrafW, G!imelius B, Pahlman Let al. Determinants ofprognosis in advanced colorectal cancer. Bur JCancer1991; 27:1119–1123.Google Scholar
  68. 68.
    Lavin P, Mittleman A, Douglass Het al. Survival and response to chemotherapy for advanced colorectal adenocarcinoma: An Eastern Cooperative Oncology Group Report. Cancer 1980; 46:1536–1543.PubMedCrossRefGoogle Scholar
  69. 69.
    Cady B, Stone MD, McDermott WV Jr. et al. Technical and biologic factors in disease-free survival after hepatic resection for colon cancer metastases. Arch Surg 1992; 127:561–569.PubMedGoogle Scholar
  70. 70.
    Tsushima K, Nagorney OM, Rainwater LMet al. Prognostic significance of nuclear deoxyribonucleic acid ploidy patterns in resected hepatic metastases from colorectal carcinoma. Surgery 1987; 102:635–643.PubMedGoogle Scholar
  71. 71.
    Kastrinakis WV, Ramchurren N, Rieger KMet al. Increased incidence ofp53 mutations is associated with hepatic metastasis in colorectal neoplastic progression. Oncogene 1995; 100:647–652.Google Scholar
  72. 72.
    Gennari L, Doci R, Bozzetti Pet al. Proposal for staging liver metastases. Recent Results Cancer Res 1986; 100:80–84.PubMedGoogle Scholar
  73. 73.
    van de Velde CJH. The staging of hepatic metastases arising from colorectal cancer. Recent Results Cancer Res 1986; 100:85–90.PubMedGoogle Scholar
  74. 74.
    Kavolius J, Pong Y, Blumgart LH. Surgical resection of metastatic liver tumors. Surg Oncol Clinics 1996; 5:337–352.Google Scholar
  75. 75.
    Jaques DP, Coit 0, Casper Eet al. Hepatic metastases from soft tissue sarcoma. Ann Surg 1995; 221:392–397.PubMedCrossRefGoogle Scholar
  76. 76.
    Ihse I, Person B, Tibblin S. Neuroendocrine metastases of the liver. World JSurg 1995; 19:76–82.Google Scholar
  77. 77.
    Moertel CG. An odyssey in the land of small tumors. JClin Onco1 1987; 5:1503–1522. Google Scholar
  78. 78.
    Thompson GB, van Heerden JA, Grant CS. Islet cell carcinomas of the pancreas: a twenty year experience. Surgery 1988; 104:1011–1017.PubMedGoogle Scholar
  79. 79.
    Que PG, Nagorney OM, Batts KPet al. Hepatic resection for metastatic neuroendocrine carcinoma. Am JSurg 1995; 169:36–43.PubMedCrossRefGoogle Scholar
  80. 80.
    Norstein J, Silen W. Natural history ofliver metastases from colorectal carcinoma. Gastrointest Surg 1997; 1:398–407.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1998

Authors and Affiliations

  • Mark J. Lieser
  • David M. Nagorney

There are no affiliations available

Personalised recommendations