TY - CHAP M1 - Book, Section TI - Treatment of Hepatic Metastasis A1 - Ronnekleiv-Kelly, Sean M. A1 - Weber, Sharon M. A2 - Zinner, Michael J. A2 - Ashley, Stanley W. A2 - Hines, O. Joe PY - 2019 T2 - Maingot's Abdominal Operations, 13e AB - Hepatic metastases to the liver are significantly more common than primary liver malignancy and comprise approximately 90% of hepatic malignancies. Each year, approximately 140,000 new cases of colorectal cancer (CRC) are diagnosed in the United States, with hepatic metastases complicating 10% to 25% of cases.1,2 Two-thirds of these patients die from their disease as a result of liver involvement.2 In addition, numerous other malignancies metastasize to the liver. For instance, approximately 50% of patients with uveal melanoma develop liver metastases within 2 to 5 years after initial diagnosis, and 90% of metastatic uveal melanoma patients die with disease burden in the liver due to inefficacious systemic ­chemotherapy.3 Neuroendocrine tumors (NETs) also have propensity to metastasize to the liver as well as breast cancer, esophageal cancer, gastric cancer, gastrointestinal stromal tumors (GISTs), sarcoma, gynecologic and urologic malignancies, and melanoma.4 Therefore, because of the significant number of patients impacted by either primary or secondary liver malignancy, there is an increasing need for effective locoregional therapy. Surgical resection as a part of multimodal therapy is generally considered the gold ­standard.5-8 However, resection is often not a reasonable option secondary to disease burden, tumor location, insufficient estimated future liver remnant, extrahepatic disease, and medical comorbidities. In fact, surgical resection for metastatic disease to the liver is only feasible in approximately 20% of patients.9 Therefore, alternative options are necessary in the 60% to 80% of patients with metastatic disease to the liver in whom surgery is not possible.9 These nonresective techniques are the focus of this chapter. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/15 UR - accesssurgery.mhmedical.com/content.aspx?aid=1160044406 ER -