Skip to main content
SpringerLink
Log in

Therapeutic modalities and prognostic factors for primary and secondary liver tumors

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

During the past decade considerable progress has been reported in the treatment of primary and secondary hepatic malignancies. Refined techniques in surgery, transplantation, radiotherapy, and chemotherapy apparently have made the delivery of treatment safer. At the same time improved understanding of tumor biology has been incorporated in treatment strategies. More recently specific and nonspecific, active and passive immunotherapies have excited wide interest, and information from the first randomized studies is now available. We review current treatment options for primary and secondary hepatic malignancies in an attempt to extract plausible treatment guidelines and to identify promising future directions.

Résumé

Pendant la dernière décennic, d'importants progrès ont été enregistrés dans le traitement des tumeurs malignes primitives et secondaires du foie. Des techniques sophistiquées dans les domaines de la chirurgie, des transplantations, de la radiothérapie et de la chimiothérapie ont toutes contribué à rendre ce traitement plus sûre. De même, une meillcure connaissance de la biologie tumorale s'est intégrée dans la stratègie thérapeutique. Plus récemment, l'immunothérapie spécifique comme non spécifique, active ou passive, s'est ajoutée avec intérêt et à présent, les résultats d'études randomisées sont disponibles. Les options thérapeutiques des tumeurs malignes primitives ou secondaires du foie sont discutées afin d'extraire les grandes lignes thérapeutiques et d'identifier les directions futures.

Resumen

En el curso del último decenio se ha informado considerable progreso en el tratamiento de los neoplasmas primarios y secundarios del hígado. Neuvas y refinadas técnicas en cirugía, trasplante, radioterapia y quimioterapia han aportado mayor seguridad a las modalidades de tratamiento. Al mismo tiempo, existe una mejor comprensión de la biología tumoral, la cual ha sido debidamente incorporada en las estrategias terapéuticas. Más recientemente, se ha despertado gran interés en cuanto a la immunoterapia específica y no específica, activa y pasiva, y ya se dispone de información sobre los primeros estudios randomizados. En el presente artículo hacemos una revisión de las opciones terapéuticas para los neoplasmas primarios y secundarios del hígado con la intención de definir guías terapéuticas plausibles y de identificar modalidades promisorias para el futuro.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Munoz, N., Bosch, X.: Epidemiology of hepatocellular carcinoma. In: Neoplasms of the Liver, K. Okuda, K.G. Ishak, editors. Heidelberg, Springer-Verlag, 1987, pp. 3–19

    Google Scholar 

  2. Bismuth, H., Morino, M., Sherlock, D., et al.: Primary treatment of hepatocellular carcinoma by arterial chemoembolization. Am. J. Surg. 163:387, 1992

    Google Scholar 

  3. Wood, W.J., Rawlings, M., Evans, H.,Lim, C.N.H.: Hepatocellular carcinoma: importance of histologic classification as a prognostic factor. Am. J. Surg. 155:663, 1988

    Google Scholar 

  4. Nagorney, D.M., van Heerden, J.A., Ilstrup, D.M., Adson, M.A.: Primary hepatic malignancy: surgical management and determinants of survival. Surgery 106:704, 1989

    Google Scholar 

  5. Bismuth, H., Chiche, L., Adam, R., Castaining, D., Diamond, T., Denison, A.: Liver resection versus transplantation for hepatocellular carcinoma in cirrhotic patients. Ann. Surg. 218:145, 1993

    Google Scholar 

  6. Yamanaka, N., Okamoto, E., Kuwata, K., Tanaka, N.: A multiple regression equation for prediction of posthepatectomy liver failure. Ann. Surg. 200:658, 1984

    Google Scholar 

  7. Yamanaka, N., Okamoto, E., Toyosaka, A., et al.: Prognostic factors after hepatectomy for hepatocellular carcinoma: a univariate and multivariate analysis. Cancer 65:1104, 1990

    Google Scholar 

  8. Nagao, T., Inoue, S., Mizuta, T., Saito, H., Kawano, N., Morioka, Y.: One hundred hepatic resections: indications and results. Ann. Surg. 202:42, 1985

    Google Scholar 

  9. Nagino, M., Nimura, Y., Hayakawa, N., et al.: Logistic regression and discriminant analyses of hepatic failure after liver resection for carcinoma of the biliary tract. World J. Surg. 17:250, 1993

    Google Scholar 

  10. Suenaga, M., Nakao, A., Harada, A., et al.: Hepatic resection for hepatocellular carcinoma. World J. Surg. 16:97, 1992

    Google Scholar 

  11. Nagasue, N., Kohno, H., Chang, Y.C., et al.: Liver resection for hepatocellular carcinoma. Ann. Surg. 217:375, 1993

    Google Scholar 

  12. Nonami, T., Isshiki, K., Katoh, H., et al.: The potential role of postoperative hepatic artery chemotherapy in patients with high risk hepatomas. Ann. Surg. 213:222, 1991

    Google Scholar 

  13. Sitzman, J.V., Abrams, R.: Improved survival for hepatocellular cancer with combination surgery and multimodality treatment. Ann. Surg. 217:149, 1993

    Google Scholar 

  14. Sugioka, A., Tsuzuki, T., Kanai, T.: Postresection prognosis of patients with hepatocellular carcinoma. Surgery 113:612, 1993

    Google Scholar 

  15. Belghiti, J., Panis, Y., Farges, Q., Benhamou, J.P., Fekete, F.: Intrahepatic recurrence after resection of hepatocellular carcinoma complicating cirrhosis. Ann. Surg. 214:114, 1991

    Google Scholar 

  16. Yuki, K., Hirohashi, S., Sakamoto, M., Kanai, T., Shimosato, Y.: Growth and spread of hepatocellular carcinoma. Cancer 66:2174, 1990

    Google Scholar 

  17. Liver Cancer Study Group of Japan: Primary liver cancer in Japan: clinicopathologic features and results of surgical treatment. Ann. Surg. 211:277, 1990

    Google Scholar 

  18. Iwatsuki, S., Starzl, T., Sheahan, D.G., et al.: Hepatic resection versus transplantation for hepatocellular carcinoma. Ann. Surg. 214:221, 1991

    Google Scholar 

  19. Tang, Z.Y., Yu, Y.Q., Zhou, X.D., et al.: Treatment of hepatocellular carcinoma: a summary of 33 years' experience. In Primary Liver Cancer in Japan, Tobe et al., editors. Tokyo, Springer-Verlag, 1992, pp. 435–441

    Google Scholar 

  20. Matsumata, T., Kanematsu, T., Tanaka, K., Sugimachi, K.: Lack of intrahepatic recurrence of hepatocellular carcinoma by temporary portal venous embolization with starch microspheres. Surgery 105:188, 1989

    Google Scholar 

  21. Fujio, N., Sakai, K., Kinoshita, H., et al.: Results of treatment of patients with hepatocellular carcinoma with severe cirrhosis of the liver. World J. Surg. 13:211, 1989

    Google Scholar 

  22. Hwang, T.L., Chen, M.F., Lee, T.Y., Chen, T.Y., Lin, D.Y., Liaw, F.Y.: Resection of hepatocellular carcinoma after transcatheter arterial embolization: reevaluation of the advantages and disadvantages of preoperative embolization. Arch. Surg. 122:756, 1987

    Google Scholar 

  23. Okuda, K., Ohnishi, K., Takayasu, K.: Arterial embolisation in the treatment of hepatocellular carcinoma. In Neoplasms of the Liver, K. Okuda, K.G. Ishak, editors. Heidelberg, Springer-Verlag, 1987, pp. 327–334

    Google Scholar 

  24. Kanematsu, T., Takenaka, K., Matsumata, T., Furuta, T., Sugimachi, K., Inokuchi, K.: Limited hepatic resection for selected cirrhotic patients with primary liver cancer. Ann. Surg. 199:51, 1984

    Google Scholar 

  25. Nagasue, N., Yukaya, H., Chang, Y.C., et al.: Assessment of pattern and treatment of intrahepatic recurrence after resection of hepatocellular carcinoma. Surg. Gynecol. Obstet. 171:217, 1990

    Google Scholar 

  26. Uchino, J., Une, Y., Nakajima, Y., et al.: Treatment of recurrent primary liver cancer. In Primary Liver Cancer in Japan, Tobe et al., editors. tokyo, Springer-Verlag, 1992, pp. 353–361

    Google Scholar 

  27. Tang, Z.Y., Yu, Y.Q., Zhou, X.D., et al.: Surgery for small hepatocellular carcinoma: analysis of 144 cases. Cancer 64:536, 1989

    Google Scholar 

  28. Lange, J.F., Leese, T., Castaing, D., Bismuth, H.: Repeat hepatectomy for recurrent malignant tumors of the liver. Surg. Gynecol. Obstet. 169:119, 1989

    Google Scholar 

  29. Nagao, T., Inoue, S., Yoshimi, F., et al.: Postoperative recurrence of hepatocellular carcinoma. Ann. Surg. 211:28, 1990

    Google Scholar 

  30. Franco, D., Smadja, C., Meakins, J.L., Wu, A., Berthoux, L., Grange, D.: Improved early results of elective hepatic resection for liver tumors. Arch. Surg. 124:1033, 1989

    Google Scholar 

  31. Nagao, T., Goto, S., Kawano, N., et al.: Hepatic resection for hepatocellular carcinoma: clinical features and long-term prognosis. Ann. Surg. 205:33, 1987

    Google Scholar 

  32. Lee, C.S., Sung, J.L., Hwang, L.Y., et al.: Surgical treatment of 109 patients with symptomatic and asymptomatic hepatocellular carcinoma. Surgery 99:481, 1986

    Google Scholar 

  33. Ringe, B., Pichlmayr, R., Wittekind, C., Tusch, G.: Surgical treatment of hepatocellular carcinoma: experience with liver resection and transplantation in 198 patients. World J. Surg. 15:270, 1991

    Google Scholar 

  34. Iwatsuki, S., Gordon, R., Shaw, B.W., Starzl, T.E.: Role of liver transplantation in cancer therapy. Ann. Surg. 202:401, 1985

    Google Scholar 

  35. Bismuth, H., Cataing, D., Ericzon, B.G., et al.: Hepatic transplantation in Europe: first report of the European Liver Transplant Registry. Lancet 2:674, 1987

    Google Scholar 

  36. Penn, I.: Hepatic transplantation for primary and metastatic cancers of the liver. Surgery 110:726, 1991

    Google Scholar 

  37. European Liver Transplant Registry: Report 10/1993 (Committee: H. Bismuth, D. Castaing, B.G. Ericzon, J.B. Otte, B. Ringe, K. Rolles, M.J.H. Slooff)

  38. Iwatsuki, S., Stazl, T.E.: Liver transplantation in the treatment of liver cancer. In Neoplasms of the Liver, K. Okuda, K.G. Ishak, editors. Heidelberg, Springer-Verlag, 1987, pp. 397–406

    Google Scholar 

  39. O'Grady, J.G., Polson, R.J., Rolles, K.: Liver transplantation for malignant disease. Ann. Surg. 207:373, 1988

    Google Scholar 

  40. Olthoff, K.M., Millis, M., Rosove, M.H., Goldstein, L.T., Ramming, K.P., Busuttil, R.W.: Is liver transplantation justified for the treatment of hepatic malignancies? Arch. Surg. 125:1261, 1990

    Google Scholar 

  41. Ismail, T., Angrisani, L., Gunson, B.K., et al.: Primary hepatic malignancy: the role of liver transplantation. Br. J. Surg 77:983, 1990

    Google Scholar 

  42. Klintmalm, G.: Hepatic transplantation for primary and metastatic cancers of the liver. Surgery 110:726, 1991

    Google Scholar 

  43. Busuttil, R.W.: Hepatic resection versus transplantation for hepatocellular carcinoma. Ann. Surg. 214:221, 1991

    Google Scholar 

  44. Turcotte, J.G. Hepatic transplantation for primary and metastatic cancers of the liver. Surgery 110:726, 1991

    Google Scholar 

  45. Chen, P.J., Chen, D.S., Lai, M.Y.: Clonal origin of recurrent hepatocellular carcinoma. Gastroenterology 96:527, 1989

    Google Scholar 

  46. Ding, S.F., Jalleh, R.P., Wood, C.B., et al.: Different DNA changes in primary and recurrent hepatocellular carcinoma. Gut 33:1433, 1992

    Google Scholar 

  47. Okuda, K., Ohtsuki, T., Obata, H., et al.: Natural history of hepatocellular carcinoma and prognosis in relation to treatment: study of 850 patients. Cancer 56:918, 1985

    Google Scholar 

  48. Schmoll, E., Schmoll, H.J., Böhmer, G., Wike, H., Poliwoda, H.: Die systemische Chemotherapie des Leberkarzinoms. In Neue Entwicklungen in der Therapie von Lebertumoren, C. Herfarth, P. Schlag, editors. Heidelberg, Springer-Verlag, 1991, pp. 31–46

    Google Scholar 

  49. Kelm, C., Henneking, K., Zimmermann, T., Vollerthun, M., Padberg, W.: Palliative Therapie primärer Lebertumoren. Langenbecks Arch. Chir. 378:195, 1993

    Google Scholar 

  50. Ong, G.B.: Techniques and therapies for primary and metastatic liver cancer. Curr. Probl. Cancer 2:5, 1977

    Google Scholar 

  51. Lee, N.W., Wong, J., Ong, G.B.: The surgical management of primary carcinoma of the liver. World J. Surg. 6:66, 1982

    Google Scholar 

  52. Okamoto, E., Tanaka, N., Yamanaka, N., Toyosaka, A.: Results of surgical treatments of primary hepatocellular carcinoma: some aspects to improve long-term survival. World J. Surg. 8:360, 1984

    Google Scholar 

  53. Ohto, M., Ebara, M., Yoshikawa, M., Okuda, K.: Radiation therapy and percutaneous ethanol injection for the treatment of hepatocellular carcinoma. In Neoplasm of the Liver, K. Okuda, K.G. Ishak, editors. Heidelberg, Springer-Verlag, 1987, pp. 335–341

    Google Scholar 

  54. Wiggers, T., Jeekel, J., Arends, J.W., et al.: No-touch isolation technique in colon cancer: a controlled prospective trial. Br. J. Surg. 75:409, 1988

    Google Scholar 

  55. Hunt, T.M., Flowerdew, A.D.S., Birch, S.J., Williams, J.D., Mullee, M.A., Taylor, I.: Prospective randomized controlled trial of hepatic arterial embolization or infusion chemotherapy with 5-fluorouracil and degradable starch microspheres for colorectal liver metastases. Br. J. Surg. 77:779, 1990

    Google Scholar 

  56. Nordlinger, B., Jaeck, D., Guiget, M., Vaillant, J.C., Balladur, P., Schaal, J.C.: Surgical resection of hepatic metastases: multicentric retrospective study by the French Association of Surgery. In Treatment of Hepatic Metastases of Colorectal Cancer, B. Nordlinger, D. Jaeck, editors. New York, Springer-Verlag, 1992, pp. 129–161

    Google Scholar 

  57. Patt, Y.Z., McBride, C.M., Ames, F.C., et al.: Adjuvant perioperative hepatic arterial mitomycin C and floxuridine combined with surgical resection of metastatic colorectal cancer in the liver. Cancer 59:867, 1987

    Google Scholar 

  58. Schlag, P., Manasterski, M., Gerneth, T., et al.: Active specific immunotherapy with Newcastle disease virus modified autologous tumor cells following resection of liver metastases in colorectal cancer: first evaluation of clinical response of a phase II trial. Cancer Immunol. Immunther. 35:325, 1992

    Google Scholar 

  59. August, D.A., Sugarbaker, P.H., Ottow, R.T., Gianola, F.J., Schneider, P.D.: Hepatic resection of colorectal metastases: influence of clinical factors and adjuvant intraperitoneal 5-fluorouracil via Tenckhoff catheter on survival. Ann. Surg. 201:210, 1985

    Google Scholar 

  60. Wagman, L.D., Kemeny, M.M., Leong, L., et al.: A prospective, randomized evaluation of the treatment of colorectal cancer metastatic to the liver. J. Clin. Oncol. 8:1885, 1990

    Google Scholar 

  61. Kemeny, N., Conti, J., Seiter, K., et al.: A phase I trial of intrahepatic fluorodesoxyuridine (FUDR) & systemic 5-fluorouracil (5-FU) + leucovorin in metastatic colorectal cancer: a useful adjuvant program after resection of colorectal metastases? Proc. Am. Soc. Clin. Oncol. 11:194, 1992

    Google Scholar 

  62. Rougier, P., Lasser, P., Elias, D.: Systemic and Local Chemotherapy in Palliative and Adjuvant Treatment of Hepatic Metastases of Colorectal Origin. New York. Springer-Verlag, 1992, pp. 109–128

    Google Scholar 

  63. Hottenrott, C., Lorenz, M.: Indikation und Stellenwert der regionalen Chemotherapie. In Neue Entwicklungen in der Therapie von Lebertumoren, C. Herfarth, P. Schlag, editors. Heidelberg, Springer-Verlag, 1991, pp. 134–140

    Google Scholar 

  64. Wolf, R.F., Goodnight, J.E., Krag, D.E., Schneider, P.D.: Results of resection and proposed guidelines for patient selection in instances of noncolorectal hepatic metastases. Surg. Gynecol. Obstet. 173:454, 1991

    Google Scholar 

  65. Starzl, T.E., Demetris, A.J., van Thiel, D.: Liver transplantation. N. Engl. J. Med. 321:1014, 1989

    Google Scholar 

  66. Pichlmayr, R., Ringe, B., Wittekind, C., et al.: Liver grafting for malignant tumors. Transplant. Proc. 21:2403, 1989

    Google Scholar 

  67. Grage, T.B., Vassilopoulos, P.P., Shingelton, W.W., et al.: Results of a prospective randomized study of hepatic artery infusion with 5-FU versus intravenous 5-FU in patients with hepatic metastases from colorectal cancer: a Central Oncology Group Study. Surgery 86:550, 1979

    Google Scholar 

  68. Kemeny, N., Daly, J., Reichman, B., Geller, N., Botet, J., Oderman, P.: Intrahepatic or systemic infusion of fluorodeoxyuridine in aptients with liver metastases from colorectal carcinoma. Ann. Intern. Med. 107:459, 1987

    Google Scholar 

  69. Chang, A.E., Schneider, P.D., Sugarbaker, P.H., Simpson, C., Cuilnane, M. Steinberg, S.M.: A prospective, randomized trial of regional versus systemic continuous 5-fluorodesoxyuridine chemotherapy in the treatment of colorectal liver metastases. Ann. Surg. 206:685, 1987

    Google Scholar 

  70. Hohn, D., Stagg, R., Friedman, M.: A randomized trial of intravenous versus hepatic intraarterial floxuridine in patients with colorectal cancer metastatic to liver: the Northern California Oncology Group trial. J. Clin. Oncol. 7:1646, 1989

    Google Scholar 

  71. Martin, J.K., O'Connell, M., Wieand, H.S.: Intra-arterial floxuridine vs systemic fluorouracil for hepatic metastases from colorectal cancer. Arch. Surg. 125:1022, 1990

    Google Scholar 

  72. Rougier, P., Hay, J.M., Ollivier, J.M.: A controlled multicentric trial of intra-hepatic chemotherapy (IHC) vs standard palliative treatment for colorectal liver metastases. Proc. Am. Soc. Clin. Oncol. 9:104, 1990

    Google Scholar 

  73. Safi, F., Bittner, R., Roscher, R., Schuhmacher, K., Gaus, W., Beger, G.H.: Regional chemotherapy for hepatic metastases of colorectal carcinoma (continuous intraarterial versus continuous intraarterial/intravenous therapy): results of controlled clinical trial. Cancer 64:379, 1989

    Google Scholar 

  74. Zukiwski, A., Wallace, S., Guterman, J., Saks, S., Mavligit, G.: Hepatic arterial infusion of recombinant tumor necrosis factor in patients with metastatic carcinoma to the liver. Proc. Am. Soc. Clin. Oncol. 8:122, 1989

    Google Scholar 

  75. Mayligit, G., Charnsangavej, C., Talpaz, M., Gutterman, J., Wallace, S.: Splenic versus hepatic artery infusion of recombinant interleukin-2 for patients with liver metastases. Proc. Am. Soc. Clin. Oncol. 7:107, 1988

    Google Scholar 

  76. Dufour, P., Husseini, F., Cure, P., et al.: Randomized study of 5-fluorouracil (5-FU) vs. 5-FU plus alpha 2A interferon (IFN) for metastic colorectal carcinoma (MCRC). Proc. Am. Soc. Clin. Oncol. 11:A583, 1992

  77. Taylor, I.: Cytotoxic perfusion for colorectal liver metastases. Br. J. Surg. 65:109, 1978

    Google Scholar 

  78. Gerard, A., Buyse, M., Pector, J.C., et al.: Hepatic artery ligation with and without portal infusion of 5 FU: a randomized trial in patients with unresectable liver metastases from colorectal carcinoma. Eur. J. Surg. Oncol. 17:289, 1991

    Google Scholar 

  79. Kanematsu, T., Sonoda, T., Takenaka, K., Matsumata, T., Sugimachi, K., Inokuchi, K.: The value of ultrasound in the diagnosis and treatment of small hepatocellular carcinoma. Br. J. Surg. 72:23, 1985

    Google Scholar 

  80. Smalley, S.R., Moertel, C.G., Hilton, J.F., et al.: Hepatoma in the noncirrhotic liver. Cancer 62:1414, 1988

    Google Scholar 

  81. Gozzetti, G., Mazziotti, A., Cavallari, A., et al.: Clinical experience with hepatic resections for hepatocellular carcinoma in patients with cirrhosis. Surg. Gynecol. Obstet. 166:503, 1988

    Google Scholar 

  82. Iwatsuki, S., Starzl, T.: Personal experience with 411 hepatic resections. Ann. Surg. 208:421, 1988

    Google Scholar 

  83. Chen, M.F., Hwang, T.L., Jeng, L.B.B., Jan, Y.Y., Wang, C.S., Chou, F.F.: Hepatic resection in 120 patients with hepatocellular carcinoma. Arch. Surg. 124:1025, 1989

    Google Scholar 

  84. Franco, D., Capussotti, L., Smadjy, C., et al.: Resection of hepatocellular carcinomas: results in 72 European patients with cirrhosis. Gastroenterology 98:733, 1990

    Google Scholar 

  85. Kim, S.T., Kim, K.P., Noh, D.Y.: Prognostic factors in surgical patients with hepatocellular carcinoma. In Primary Liver Cancer in Japan, Tobe et al., editors. Tokyo, Springer-Verlag, 1992, pp. 421–426

    Google Scholar 

  86. Ouchi, K., Matsubara, S., Fukuhara, K., Tominaga, T., Matsuno, S.: Recurrence of hepatocellular carcinoma in the liver remnant after hepatic resection. Am. J. Surg. 166:270, 1993

    Google Scholar 

  87. Hsu, H.C., Wu, T.T., Wu, M.Z., Sheu, J.C., Lee, C.S., Chen, D.S.: Tumor invasiveness and prognosis in resected hepatocellular carcinoma: clinical and pathogenetic implications. Cancer 61:2095, 1988

    Google Scholar 

  88. Kinami, Y., Takashima, S., Miyazaki, I.: Hepatic resection for hepatocellular carcinoma associated with liver cirrhosis. World J. Surg. 10:294, 1986

    Google Scholar 

  89. Nagasue, N., Yukaya, H., Okawa, Y., Sasaki, Y., Chang, Y.C.: Clinical experience with 118 hepatic resections for hepatocellular carcinoma. Surgery 99:694, 1986

    Google Scholar 

  90. Lai, E.C.S., Ng, I.O.L., You, K.T., et al.: Hepatectomy for large hepatocellular carcinoma: the optimal resection margin. World J. Surg. 15:141, 1991

    Google Scholar 

  91. Matsuda, Y., Ito, T., Oguchi, Y., Nakajima, K., Izukura, T.: Rationale for surgical management for recurrent hepatocellular carcinoma. Ann. Surg. 218:28, 1993

    Google Scholar 

  92. Pichlmayr, R., Weimann, A. Steinhoff, G., Ringe, B.: Liver transplantation for hepatocellular carcinoma: clinical results and future aspects. Cancer Chemother. Pharmacol. 31 (Suppl.):S157, 1992

    Google Scholar 

  93. Foster, J.H.: Treatment of metastatic disease of the liver: a skeptic's view. Semin. Liver Dis. 4:170, 1984

    Google Scholar 

  94. Ringe, B., Bechstein, W.O., Raab, R., Meyer, H.J., Pichlmayr, R.: Leberresektion bei 157 Patienten mit colorectalen Metastasen. Chirurg 61:272, 1990

    Google Scholar 

  95. Doci, R., German, L., Bigmani, P., Montallo, F., Moranito, A., Bozzetti, F.: One hundred patients with hepatic metastases from colorectal cancer treated by resection: analysis of prognostic determinants. Br. J. Surg. 78:797, 1991

    Google Scholar 

  96. Hughes, K.S., Simon, R., Songhorabodi, S., et al.: Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of patterns of recurrence. Surgery 100:278, 1986

    Google Scholar 

  97. Scheele, J., Stangl, R., Altendorf-Hofmann, A., Gall, F.P.: Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 110:13, 1991

    Google Scholar 

  98. Van Oojien, B., Wiggers, T., Mejier, S., et al.: Hepatic resection for colorectal metastases in The Netherlands. Cancer 70:28, 1992

    Google Scholar 

  99. Rosen, C.B., Nagorney, D.M., Taswell, H.F., et al.: Perioperative blood transfusion and determinants of survival after liver resection for metastatic colorectal carcinoma. Ann. Surg. 216:493, 1992

    Google Scholar 

  100. Pancera, G., Nitti, D., Civalleri, D., et al.: A retrospective analysis of 119 patients with resected metastases from colorectal cancer: is there a role for adjuvant chemotherapy?. Proc. Am. Soc. Clin. Oncol. 11:117, 1992

    Google Scholar 

  101. Hughes, K.S., Rosenstein, R., Songhorabodi, S., et al.: Resection of the liver for colorectal carcinoma metastases—a multi-institutional of long-term survivors. Dis. Colon Rectum 31:1, 1988

    Google Scholar 

  102. Hughes, K.S., Rosenstein, R., Simon, R., et al.: Resection of the liver for colorectal metastases—a multi-institutional study of indication for resection. Surgery 103:278, 1988

    Google Scholar 

  103. Fortner, J.G., Silva, J.S., Golbey, R.B., Cox, E.B., MacLean, B.J.: Multivariate analysis of a personal series of 247 consecutive patients with liver metastases from colorectal cancer. Ann. Surg. 199:306, 1984

    Google Scholar 

  104. Ekberg, H., Tranberg, K.G., Andersson, R., et al.: Determinants of survival in liver resection for colorectal secondaries. Br. J. Surg. 73:727, 1986

    Google Scholar 

  105. O'Connell, M.J., Adson, M.A., Schutt, A.J., Rubin, J., Moertel, C.G., Ilstrup, D.M.: Clinical trial of adjuvant chemotherapy after surgical resection of colorectal cancer metastatic to the liver. Mayo Clin. Proc. 60:517, 1985

    Google Scholar 

  106. Elias, D., Lasser, P., Rougier, P., Nitenberg, G., Theodore, C., Lumbroso, J.: Early adjuvant intraportal chemotherapy after curative hepatectomy for colorectal liver metastases—a pilot study. Eur. J. Surg. Oncol. 13:247, 1987

    Google Scholar 

  107. Barone, R., Goldfarb, P., Saleh, F., Kogler, J., Shiftan, T., Weiss, R.: Liver resection and adjuvant intra-arterial FUDR therapy for the treatment of metastatic colon carcinoma. Proc. Am. Soc. Clin. Oncol. A443, 1990

  108. Moriya, Y., Sugihara, K., Hojo, K., Makuuchi, M.: Adjuvant hepatic intra-arterial chemotherapy after potentially curative hepatectomy for liver metastases from colorectal cancer: a pilot study. Eur. J. Surg. Oncol. 17:519, 1991

    Google Scholar 

  109. Tsujitani, S., Watanabe, A., Kakeji, Y., et al.: Hepatic recurrence not prevented with low dosage long-term intraportal 5-FU infusion after resection of colorectal liver metastases. Eur. J. Surg. Oncol. 17:526, 1991

    Google Scholar 

  110. Hughes, K., Foster, J., et al.: The role of adjuvant chemotherapy following curative hepatic resection of colorectal metastases. Proc. Am. Soc. Clin. Oncol. 10:145, 1991

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany

    Thomas Lehnert M.D., Gerd Otto M.D. & Christian Herfarth M.D.

Authors
  1. Thomas Lehnert M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gerd Otto M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Herfarth M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lehnert, T., Otto, G. & Herfarth, C. Therapeutic modalities and prognostic factors for primary and secondary liver tumors. World J. Surg. 19, 252–263 (1995). https://doi.org/10.1007/BF00308635

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00308635

Keywords

Search

Navigation