Controlling Liver Metastases in Colorectal Cancer

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Despite efforts to control metastatic colorectal cancer (CRC) with chemotherapy, the disease eventually spreads in approximately 60% of patients. The organ that is most affected by this growth is the liver, says Marwan Fakih, MD. This spread and associated liver failure is the primary cause of death in patients with CRC, making control of liver metastases an important factor in overall survival, comments Fakih.

Several prognostic scores have been developed to help determine who is fit to undergo liver resection for patients with CRC and liver metastases. These scores also help predict if patients have a high likelihood of cure with surgery. These prognostic variables include the number of lesions in the liver, the size of the largest lesion in the liver, whether the liver metastases occurred at the same time a patient was diagnosed with CRC, lymph node involvement, and the levels carcinoembryonic antigen (CEA).

While a high prognostic score predicts that disease is more likely to recur, it does not mean these individuals will not benefit from surgery, says Fakih. It means that they are less likely to be cured with surgery, but they could have a survival benefit.