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Resection and embolization in the management of secondary hepatic tumors

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Abstract

The management of hepatic metastases either by means of hepatic resection or by hepatic artery embolization is reviewed. Hepatic resection is of value either as a palliative or potentially curative measure, especially in secondary deposits arising from primary sites in the colorectum. Approximately 26% of patients with primary colorectal cancer will have hepatic metastases at diagnosis and, of these, some 5–10% will be amenable to resection. Untreated, all patients die within 5 years, but resection of solitary metastases would appear to offer a 20% chance of 5-year survival. Better results have been obtained with resection carried out for smaller lesions. Major resections carried out for large lesions are not as successful.

Hepatic artery embolization is useful in a wide variety of secondary hepatic deposits, not only to treat local symptoms but also to ameliorate the systemic effects produced by secondary deposits arising from primary endocrine tumors. Controlled clinical studies allowing comparison of the results of tumor embolization with those of other forms of palliative therapy or of symptomatic treatment are now necessary.

Résumé

Le tritement des métastases hépatiques par la résection hépatique ou par l'embolisation de l'artère hépatique est étudié dans cet article. La résection hépatique présente une valeur palliative et mÊme curative lorsque les métastases proviennent d'une lésion néoplasique colique ou rectale. Environ 26% des malades qui présentent un cancer colique ou rectal sont porteur de métastases hépatiques au moment où la lésion primitive est reconnue. Cinq à 10% des métastases sont susceptibles d'Être réséquées. Si les métastases ne sont pas réséquées tous les malades qui en sont porteur meurent en moins de 5 ans alors que la résection des métastases solitaires se solde par 20% de guérison au-delà de 5 ans. Les meilleurs résultats sont obtenus quand les métastases sont peu importantes.

L'embolisation de l'artère hépatique est un procédé utile de traitement des métastases hépatiques. Non seulement elle agit sur la symptomatologie locale mais elle permet d'améliorer les effets généraux qui sont produits par les tumeurs d'origine endocrinienne.

Des études plus précises permettant de comparer les résultats de l'embolisation et des autres procédés thérapeutiques sont nécessaires avant de porter un jugement définitif.

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Authors and Affiliations

  1. Department of Surgery and Diagnostic Radiology, Royal Postgraduate Medical School, Hammersmith Hospital, London, England

    Leslie H. Blumgart M.D., F.R.C.S. & David J. Allison M.D., F.R.C.R.

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  1. Leslie H. Blumgart M.D., F.R.C.S.
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  2. David J. Allison M.D., F.R.C.R.
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Blumgart, L.H., Allison, D.J. Resection and embolization in the management of secondary hepatic tumors. World J. Surg. 6, 32–45 (1982). https://doi.org/10.1007/BF01656371

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