Department of surgery


– liver metastases

Liver metastases are tumors which have spread towards the liver from other parts of the your body. Cancer cells frequently have aggressive habits and can invade other parts of the body. They often do so by floating within the bloodstream stream and then replicating themselves inside a new place. The liver, particularly, provides a fertile soil for metastatic spread due to its wealthy bloodstream supply and the existence of humoral factors (other body fluids) that promote cell growth. When it comes to bloodstream flow each minute, the bloodstream way to obtain the liver is second only to the lung.

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800px -Multiple Liver Mets 2008

 Axial CT from the abdomen showing multiple liver metastases. Image thanks to James Heilman, MD / Wikimedia Commons / CC-BY-SA-3.

The chance of cancer distributing towards the liver depends on the website from the original cancer.

For instance, cancers from the GI tract frequently spread towards the liver as their bloodstream drains directly with the liver. Melanoma usually spreads with the body’s bloodstream vessels towards the liver. Liver metastases are sometimes present  once the original (primary) cancer is diagnosed, or it might occur several weeks or years following the primary tumor is taken away.

Following the lymph nodes, the liver is easily the most common site of metastatic spread. Most liver metastases originate from the colon, rectum, pancreas, stomach, wind pipe, breast, lung, melanoma and some less frequent sites.

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Primary sites of metastases for many common cancer types, showing liver because the target for a lot of types. Primary cancers are denoted by "…cancer" as well as their primary metastasis sites are denoted by "…metastases. Image courtesy of Mikael Häggström / Wikimedia Commons / CC-BY-SA-3.

Nearly all liver metastases present as multiple tumors. Only 10% of cases present with a solitary metastatic lesion. Furthermore, in more than three-quarters (3/4) of patients with liver metastases,   there’s participation of both lobes of the liver.

Several factors influence the incidence and pattern of liver metastases. Included in this are a person’s sex and age, the main site, the histologic type, and also the time period of the tumor. Inside a couple of tumor types, for example colonic carcinoma, carcinoid, and hepatocellular carcinoma (HCC), metastasis is limited towards the liver. Most tumors that metastasize towards the liver, for example breast and lung cancers, spread with other sites simultaneously.

Colorectal Liver Metastases

Colorectal cancer frequently metastasizes to the liver. Patients presenting with operable liver metastases often receive chemotherapy adopted by surgery to get rid of all visible disease, and then additional chemotherapy to eliminate non-visible microscopic disease. Patients with advanced colorectal cancer whose liver metastases are not amendable to surgery can always take advantage of Radiofrequency Ablation (RFA) and Microwave Ablation (MWA) along with other therapeutic options.


How good patients do depends upon the position of the original cancer and just how much it’s spread towards the liver. In a small amount of cases, surgery to get rid of the liver tumors can lead to a remedy. Normally, this is only possible in patients with certain tumor types (for instance, colorectal cancer), so when there’s a small group of tumors within the liver.

Generally, cancer which has spread towards the liver isn’t curable. However, the treatments discussed above might help shrink tumors, improve existence expectancy, as well as reducing signs and symptoms.

Signs and symptoms of Liver Metastases

When signs and symptoms occur, they might include:

  • Anorexia
  • Fevers
  • Jaundice
  • Nausea
  • Discomfort, usually within the upper right area of the abdomen
  • Sweats
  • Weight loss 
  • Tests to Identify Liver Metastases include:

    • Bilirubin bloodstream test
    • CT scan or MRI
    • Liver function tests
    • PET scan
    • Ultrasound from the liver
    • Treatment
    • Treatment

      Previously, liver metastases were considered generally inoperable and treated with only palliative measures.  More lately, however, there has been a paradigm shift in the management of liver metastases. Aggressive surgical resection followed by chemotherapy has become utilized in a select number of patients . Even for inoperable tumors, treatment modalities such as Radiofrequency Ablation (RFA) and Microwave Ablation (MWA) hold great promise for improving survival.  

      Treatment depends upon the kind of primary cancer site, the level of spread towards the liver (eg. one tumor versus. many tumors), whether the cancer has spread with other organs aside from the liver, and the patient’s overall condition. Once the spread is restricted towards the liver, systemic chemotherapy can always be utilized. However, other treatment options might be effective. Once the tumor is just inside a couple of regions of the liver, cancer might be removed with surgery.

      Once the cancer has spread towards the liver along with other organs, whole-body (systemic) chemotherapy is often the management of choice. Radiofrequency waves or injection of toxins could also be used.  When bigger regions of the liver are participating, treatment may involve chemotherapy into the liver, or perhaps a procedure to bar bloodstream flow to areas of the liver (embolization) to "starve" the tumor cells. 

      Possible Complications

      Complications are usually caused by tumors distributing to some large part of the liver. They are able to include:

      • Blockage from the flow of bile
      • Decreased appetite
      • Fever
      • Liver failure (usually only within the late stages of disease)
      • Discomfort
      • Weight reduction
      • Resourse:–procedures/

        Cutting Edge: The University of Minnesota Department of Surgery