Dear Patients,

Liver metastases - what are the treatment modalities available today?

Critical Comments:

Dabei sind die vorkommenden Verfahren entweder isoliert oder in Kombination einzusetzen.
In about one-fourth of all patients with intestinal tumors already have metastases in other organs at the time of diagnosis. In about 75% of cases it is liver where the metastases are found, 25% of cases have metastases in lymph nodes and lungs.
In modern oncology there are possibilities of effective treatment of metastases in liver, lungs and lymph nodes.

There are following therapy methods:

1. Systemic chemotherapy (whole body chemotherapy). This is done today with modern drugs 5-Fu in combination with Irinotecan and Oxaliplatin.
2. Operation with tumor excision: Liver resection / Lung resection (only in small percentage of patients).
3. Regional chemotherapy: Chemoembolisation / regional chemotherapy with perfusion.
4. Minimal invasive therapy strategy
5. Laser-induced thermotherapy
6. Radio-frequence therapy
7. Kryrotherapie

Combination therapy:

Chemotherapy with Laser;
Local Chemotherapy with Laser ( LITT )

Which therapy?

An individual therapy concept needs to be conceived for every therapy decision. Chances of success are evaluated according to the extent of involvement of liver and the lung.

Requirements and Criteria:

In order to obtain a sinful therapy of liver and lung metastases a previous radical operation or resection of the primary tumor is necessary.
The general health condition of the patient must be stable enough inorder to be able to tolerate the planned therapy.

Depending on this, one can decide whether a surgical or minimal invasive method is to be chosen for the patient.

Following combination therapies are possible

1. Systemic chemotherapy: the cytostatic medication are injected through the arm vein or a port catheter. Regional Chemotherapy: the cytostatic medications are administered through a port system through a catheter direct into the liver.
2. Operation plus chemotherapy agains liver and lung metastases:
3. Laser therapy against metastases ( LITT )

The inclusion criteria are as follows:

• Up to 5 metastases with a maximal diameter of 8 cm,
• Recurrence of metastases after operative removal of previous metastases,
• When metastases tend to grow further despite chemotherapy,
• When both lobes of liver are affected,
• When an operation or chemotherapy is not possible.

About 1 to 2 metastases are treated at each LITT-sitting.
Each sitting lasts about 1 hour and can be done on an outpatient basis.
More than 5000 patients have been treated worldwide with LITT, at the University Hospital Frankfurt alone about 1300 patients have been treated with this method.

 

Document Date: 2005/08/13   Author: Ahmed Koujan

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