Several clinical scenarios can occur in patients with liver metastases from bowel cancer. Some of these are reported here as a Q/A format.
Q. Can liver metastases be operated if the patient does not respond to chemotherapy?
A. Yes, surgery is still possible, although the outcome is probably not as good as in responders.
Q. Can chemotherapy be administered directly into the liver?
A. Yes, it is called intra-arterial chemotherapy and is not commonly used in the UK. Few centres in France and in the US favour this approach, though it requires an invasive procedure to inject the drugs directly into the hepatic artery and does not provide any real advantage in terms of response or survival benefit when compared to the standard treatment
Q. What are the symptoms when bowel cancer spread to the liver?
A. They are non specific, very rarely pain or jaundice, most commonly malaise and weight loss
Q. If a metastasis in the liver is found on a scan, should it be biopsied?
A. No, because of the risk of spreading the tumour along the needle track.
Q. Can liver metastases be removed at the same time as the bowel cancer?
A. Yes, if the overall operative risk of the two major operations is acceptable
Q. Can liver metastases from other tumours be operated?
A. Yes, liver metastases from other tumours can also be considered for surgery, such as those ones from neuroendocrine tumours, renal and breast cancer.