Was a metastatic focus found in your liver? Do you have stage 4 cancer and further treatment is not indicated? Have you been denied a previously scheduled surgery because metastases were found in your liver? Have you had a successful intestine surgery, were prescribed chemotherapy, and during a follow-up examination hepatic metastases were found? Where to seek assistance, and who offers the best treatment for hepatic cancer metastases? Is it possible to radically remove all metastases from the liver? How to prolong life with hepatic cancer metastases?
Who is this article for?
These and other questions are answered by Petr Sergeevich Sergeev, Candidate of Medical Science, Head of Oncology Department of the Clinic Medicine 24/7.
In this article, we are going to speak in a simple, understandable, and at the same time scientific language about a very serious problem - a general misconception about the impossibility of further cancer treatment, if even a single metastatic focus is found in the liver. This is actually a criminal misconception that has destroyed numerous human lives.
Therefore, the text below is intended specifically for “advanced” patients and their relatives who do not want to sit passively by and await the time when only morphine would help, and who want to save the life for themselves or for their loved ones as much as possible.
We hope that this text will be useful to allied physicians, first of all, to non-operating oncologists (from among former therapists who have been retrained in oncology), chemotherapists in polyclinics and day inpatient facilities, gastroenterologists, ultrasound, computer and magnetic resonance tomography specialists, especially those who diagnosed hepatic cancer metastases and actually gave their patient up for lost.
If you are a patient, or an expert physician, send us the examination findings, the oncologist conclusion, and a link to an ultrasound scan, a MRI or CT video archive, and we will be happy to advise you free of charge. Within 24 hours you will receive an opinion about the prospects of organ-preserving liver surgery, or the possibility of performing chemoembolization of hepatic cancer foci. In some cases, we completely dismiss the diagnosis “hepatic cancer metastasis”, which turns out to be a liver cyst, parasitic liver lesion, a consequence of toxic liver damage, or even a benign tumor.
If we agree to a specific type of intervention, be it radiofrequency ablation, liver resection, including its atypical options, chemoembolization, intraarterial chemotherapy, combined intervention, it means that we guarantee the result in the form of the patient's return to active work.
Submitting your questions you should know that I, Alexei Nikolaevich Severtsev, will answer them personally.
In patients with metastases of pancreatic cancer, with multiple lesions, planned extensive resections, we hold a case conference with one of the leading national hepatobiliary zone experts, Professor Alexei Nikolaevich Severtsev (Russia).
Effective treatment methods for metastatic liver cancer are atypical resections, radiofrequency ablation, chemoembolization.
What are hepatic cancer metastases?
Hepatic cancer metastases are secondary foci that develop from seeding of tumor cells of the main, “maternal” tumor, which invaded the liver with a blood or lymph stream and proliferated to a size of 0.5 mm, minimally diagnosable by non-invasive methods.
Scientific literature contains very scarce information about hepatic cancer micrometastases. The liver is affected by metastases with almost the same frequency as lymph nodes. Almost every third patient with cancer, regardless of the localization of the primary tumor, reveals metastatic lesions of the liver with in-depth diagnostics methods.
The primary focuses for hepatic metastases are the following cancers in descending order:
- rectal cancer, sigmoid and colon (colorectal) cancer, which metastasizes in 15 to 35% of cases depending on the histological type;
- gastric cancer that metastasizes with a frequency of 17% to 85%;
- pancreatic cancer - at an average of 40%; lung cancer - 15-75%;
- mammary cancer - 20–65%.
Significantly less frequent metastases of ovarian, cervical, kidney cancer, melanoma and other types can be found in the liver.
Survival prognosis with hepatic cancer metastases
Life expectancy is different with primary detection of cancer metastases in the liver in the absence of a diagnosis of “cancer”, and with metastases against the background of treatment of an already diagnosed cancer.
Without taking into account the results of histological and immunohistochemical study of the hepatic metastasis biopsy, it is considered that the life expectancy of a patient with such a diagnosis without treatment is 4-8 to maximum 12 months from the moment of detection of the first metastasis.
With various treatment options for both hepatic metastases and the primary focus of the malignant tumor, life expectancy can be increased to 3.5 - 5 years.
Statistics shows that the absolute factors determining life expectancy are the source of metastases and the development of the main tumor process (in the intestine, pancreas, etc.), as well as the patient’s sex, age and presence of concomitant diseases. According to the national data, the survival rate of women is higher compared with men.
Life expectancy prognosis
Life duration with hepatic cancer metastases is determined by a combination of factors. The maximum life expectancy have patients with single (solitary) nodes up to 3 cm in diameter, located in the right hepatic lobe. The minimum expectancy have patients with bilobar liver affection, that is, both in the right and left lobe, with multiple heterogeneous nodes.
Chemotherapy as such is almost never used to treat metastatic liver cancer. Chemotherapy can increase the life expectancy of patients with hepatic cancer metastases to 1.5-2 years. Moreover, polychemotherapy (PCT) of the primary cancer focus and anti-relapse chemotherapy gain a particular importance.
The main methods of treatment that ensures the long-term survival of patients with hepatic cancer metastases are radical, including surgery, chemoembolization, radiofrequency ablation of foci and other less common methods.
In fact, surgical resection of the liver can be performed by a totality of factors only in 5-20% of patients with various tumors with hepatic metastases. Chemoembolization and radiofrequency ablation can bring this share to about 50% of all patients with hepatic cancer metastases. Unfortunately, up to 50% of all patients have to be content with palliative or symptomatic treatment.