However, someone with a wide spread metastasis of the primary colorectal cancer, probably should go straight to chemotherapy to reduce the tumor burden and then consider the impact of the primary lesion and the liver lesion on the quality of life. We are hoping that we can turn stage IV colorectal cancer into a chronic disease as opposed to having a terminal disease. Chemotherapy in different levels and molecular profiling will likely help us establish the treatment plan that we need for those patients who present with an advanced stage.What are a surgeon’s options for treating liver metastasis?
The team at our institution now has multiple modalities available for treating liver metastasis. Options include the Gamma Knife, radiofrequency ablation, wedge resection, and formal segmental resection. We also have used ex-vivo resection and replantation of the liver to remove the entire tissue burden. If you have a patient who is difficult to manage, we have been able to find some approach that will give them short-term, if not long-term, capability for outcomes.