Hepatic Artery Ligation for Liver Cancer
This chapter describes techniques for interrupting the blood supply to tumors metastatic to the liver and to primary tumors of the liver, and reviews the results observed with these methods. Generally, regional treatment of hepatic metastases has been limited to tumors that arise from the abdominal gastrointestinal tract. Hepatic-dominated metastases are observed more often in certain types of gastrointestinal tumors. For example, carcinomas of the esophagus rarely metastasize solely to the liver, whereas colorectal, carcinoid tumors of the gastrointestinal tract, islet cell tumors of the pancreas, and leiomyosarcomas of the intestinal tract have a unique predisposition for hepatic-only metastases. Isolated hepatic metastases are common for choroidal or retinal melanomas, but these metastases seldom respond to even the most aggressive regional therapy. Metastases from other nongastrointestinal primary tumors, e.g., lung cancer, are rarely confined to the liver. Relative tumor vascularity would be expected to be an important factor determining tumor responsiveness to blood flow interruption. Primary hepatomas tend to be vascular, and metastastic tumors tend to vary in vascularity (table 7–1). Typically hypervas-cular metastatic tumors are hypernephromas, leiomyosarcomas, carcinoid tumors, islet cell and papillary cell tumors of the pancreas, and transitional cell carcinomas.
KeywordsHepatic Artery Hepatic Metastasis Carcinoid Tumor Islet Cell Tumor Infusion Chemotherapy
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