Liver Metastases

Diamantis I. Tsilimigras, Pnina Brodt, Pierre-Alain Clavien, Ruth J. Muschel, Michael D'Angelica, Itaru Endo, Rowan W Parks, Majella Doyle, Eduardo de Santibanes, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Liver metastases are commonly detected in a range of malignancies including colorectal cancer (CRC), pancreatic cancer, melanoma, lung cancer and breast cancer, although CRC is the most common primary cancer that metastasizes to the liver. Interactions between tumour cells and the tumour microenvironment play an important part in the engraftment, survival and progression of the metastases. Different cells including liver sinusoidal endothelial cells, Kupffer cells, hepatic stellate cells, parenchymal hepatocytes, dendritic cells, resident natural killer cells as well as other immune cells such as monocytes, macrophages and neutrophils are implicated in promoting and sustaining metastases in the liver. Four key phases (microvascular, pre-angiogenic, angiogenic and growth phase) have been identified in the process of liver metastasis. Imaging modalities such as ultrasonography, CT, MRI and PET scans are typically utilized for the diagnosis of liver metastases. Surgical resection remains the main potentially curative treatment among patients with resectable liver metastases. The role of liver transplantation in the management of liver metastasis remains controversial. Systemic therapies, newer biological agents (for example, bevacizumab and cetuximab) and immunotherapeutic agents have revolutionized the treatment options of liver metastases. Moving forward, ncorporation of genetic tests can provide more accurate information to guide clinical decision making and predict prognosis among patients with liver metastases.
Original languageEnglish
JournalNature
DOIs
Publication statusPublished - 15 Apr 2021

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