RT Book, Section A1 Worni, Mathias A1 Clary, Bryan M. A2 Morita, Shane Y. A2 Balch, Charles M. A2 Klimberg, V. Suzanne A2 Pawlik, Timothy M. A2 Posner, Mitchell C. A2 Tanabe, Kenneth K. SR Print(0) ID 1145764114 T1 Non-colorectal, Non-neuroendocrine Liver Metastases T2 Textbook of Complex General Surgical Oncology YR 2018 FD 2018 PB McGraw-Hill Education PP New York, NY SN 9780071793315 LK accesssurgery.mhmedical.com/content.aspx?aid=1145764114 RD 2024/10/09 AB The liver is one of the most common sites of metastatic involvement for not only gastrointestinal malignancies, but also for a broad spectrum of cancers. While for gastrointestinal malignancies the pattern of blood flow via the splanchnic system seems an obvious explanation, many other malignancies (ocular melanoma and medullary thyroid carcinoma as examples) must offer other explanations likely revolving around the unique environment present with the liver. Local interventions including partial hepatectomy have been advocated for cancers whose dominant site of metastasis involves the liver, including colorectal cancer and gastrointestinal neuroendocrine cancers. Early experiences in partial hepatectomy and other local interventions for metastatic colorectal cancer defied commonly held (and largely accurate) perceptions that as a systemic matter cure would be unlikely. Although randomized trials comparing resection to observation or systemic therapy alone do not exist, large experiences have contributed to a general acceptance of the role for local hepatic treatments in metastatic colorectal cancer when confined to the liver or even in the presence of controlled, minimal volume at extrahepatic sites. This argument is supported by the positive 5-year survival rates after resection of colorectal liver metastases that is reaching 40% to 71%.1-5 Local treatments for hepatic metastases are also generally accepted in patients with gastrointestinal neuroendocrine malignancies, given the fact that hepatic dominant pattern is present in many patients and that uncontrolled hepatic tumor burdens are often the cause of ultimate demise in these otherwise “indolent” or slowly progressing malignancies.