What Is Involved in Metastatic Liver Cancer Treatment?

Metastatic liver cancer refers to the metastasis of cancers in various organs throughout the body to the liver. The incidence of primary liver cancer and metastatic liver cancer in China is relatively close. Secondary liver cancer is sometimes difficult to distinguish from primary liver cancer. When the primary cancer is relatively insidious, the early diagnosis of secondary liver cancer in the subclinical stage is difficult. Most of them are found during preoperative examination, postoperative follow-up or laparotomy for primary cancer.

Basic Information

English name

liver metastatic carcinoma

Visiting department

Oncology

Common locations

liver

Common causes

Metastasis of various organ malignant tumors

Common symptoms

Liver pain, bloating, discomfort, fatigue, wasting, fever, loss of appetite, epigastric mass, etc.

Causes of metastatic liver cancer

Malignant tumors of all organs throughout the body can metastasize to the liver. The invasion and metastasis of cancer cells mainly depend on their own malignant biological characteristics and their immune status. There are four ways to transfer to the liver: portal vein, hepatic artery, lymphatic pathway, and direct infiltration.

Clinical manifestations of metastatic liver cancer

The clinical manifestations of secondary liver cancer are similar to those of primary liver cancer, but with no cirrhosis, the symptoms are mild. In the early stage, it is mainly the symptoms of the primary lesion, and the symptoms of the liver itself are not obvious, and most of them are found during preoperative examination, postoperative follow-up or laparotomy for primary cancer. With the development of the disease, the tumor increased, and the patient developed symptoms such as liver pain, bloating, discomfort, fatigue, wasting, fever, loss of appetite, and epigastric mass. In the later stage, jaundice, ascites and cachexia occur. There are also a few patients with obvious liver metastases, but the primary lesions are not concealed.

Examination of metastatic liver cancer

1. Most patients with secondary liver cancer have tumor markers within the normal range, but a few liver metastatic cancers from the stomach, esophagus, pancreas and ovary may have elevated AFP.

2. Symptoms are usually accompanied by elevated ALP and GGT.

3. The increase of CEA in carcinoembryonic antigen is helpful for the diagnosis of liver metastases. The positive rate of CEA in liver metastasis of colorectal cancer is as high as 60% -70%.

4. Selective liver angiography can find lesions with a diameter of 1cm.

5. Ultrasound imaging can show 2cm mass. For those with symptoms, the positive rate of each localization diagnosis method can reach 70% to 90%.

6. Selective abdominal or hepatic arteriography mostly shows oligovascular tumors;

7. CT manifests as mixed uneven or low-density placeholders, typically showing "bull's eye" signs;

8. MRI examination of liver metastatic cancer often shows that the signal intensity is uniform, clear and frequent, and a few have "target" signs or "bright ring" signs.

Diagnosis of metastatic liver cancer

1. Patients with a history of primary cancer or clinical manifestations of liver tumors;

2. No other abnormal liver function and positive enzymes;

3. Imaging examination showed parenchymal liver mass lesions, mostly scattered or multiple;

4. Confirmed by laparoscopy or liver puncture;

5. Liver metastasis is found in the primary disease. The diagnosis depends on pathological examination.

Differential diagnosis of metastatic liver cancer

Secondary liver cancer should be identified from the following diseases.

Primary liver cancer

Hepatic disease background, hepatitis B or C markers are often positive; often with liver cirrhosis; blood AFP often rises significantly; B-mode usually shows a substantially heterogeneous light mass, some with halo; color Doppler often shows rich Blood flow, measurable arterial spectrum, resistance index is often greater than 0.60; arterial phase of CT enhanced scan often shows enhancement effect, but venous phase enhancement effect is weakened, showing the characteristics of "fast in and fast out"; cardia vein tumor thrombus is almost the original Characteristic signs of primary liver cancer.

Cavernous hemangioma of the liver

Slow development, long course of disease, and mild clinical manifestations; Ultrasound B is mostly strong echo light group with reticular structure; Color Doppler ultrasound does not show rich color blood flow, rare arterial spectrum; CT contrast scan shows contrast agent filling , The periphery spread to the center, the delayed image was still high density; liver blood pool scan was positive.

3. liver abscess

Has a history of extrahepatic (especially biliary) infection, often with chills and high fever; The total number of white blood cells and the number of neutrophils often increase; Ultrasound B can show hypoechoic space, and sometimes liquid level; CT shows low density space , No enhancement after injection of contrast agent; liver puncture examination if necessary, sometimes pus can be drawn.

Metastatic liver cancer treatment

Surgical resection is the most important method to cure secondary liver cancer. If liver cancer cannot be removed, palliative care is limited to improving quality of life and extending survival. It is important to find the primary foci and develop a personalized comprehensive treatment plan.