chapter  2
20 Pages

Treatment options for patients with primary and secondary liver cancer: An overview of invasive, minimally invasive, and noninvasive techniques

WithRicardo Paz-Fumagalli, David M. Sella, Gregory T. Frey

Liver cancer occurs when cellular proliferation within the liver escapes normal control mechanisms, exhibits aggressive behavior, and reaches or invades other body parts causing deterioration of the patient’s well-being and shortening of the patient’s life expectancy. It may start in the liver (primary) or reach the liver from another origin (secondary or metastatic). e signs and symptoms

of liver cancer are generally determined by the tumor size, number, location, proximity to vulnerable structures, rate of growth, production of substances, pattern of spread, and underlying condition of the patient’s organ systems. Oncologists study cancer populations rather than individuals and express outcomes in statistical terms that reect cancer control or freedom from cancer (overall survival, median survival, cancer-specic survival, disease-free survival, progression-free survival, time-to-progression) or can reect

2.1 Introduction 33 2.2 Approaches to the patient with

hepatic malignancy 34 2.3 Systemic therapies 34 2.4 Locoregional therapies 35

2.4.1 Surgery 35 2.4.2 Tumor ablation 36 2.4.3 Transarterial therapy 38

2.5 Hepatocellular cancer 42 2.5.1 Surgical resection and liver

transplantation for HCC 43 2.5.2 Tumor ablation for HCC 43 2.5.3 Chemoembolization for HCC 43 2.5.4 Radioembolization for HCC 43 2.5.5 Systemic therapy for HCC 43

2.6 Colorectal liver metastases 44 2.6.1 Medical therapy for CRC 44 2.6.2 Surgical therapy for CRC 44 2.6.3 Chemoembolization for CRC 44 2.6.4 Radioembolization 44 2.6.5 Tumor ablation for CRC 45

2.7 Metastatic NET 45 2.7.1 Surgery for NET 45 2.7.2 Tumor ablation for NET 46 2.7.3 Systemic therapy for NET 46 2.7.4 Transarterial therapy for NET 46

2.8 Intrahepatic cholangiocarcinoma 47 References 47

improvement, maintenance, or deterioration of quality of life.