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Colorectal Cancer Liver Metastasis

The liver is the primary target organ for hematogenous metastasis of colorectal cancer, with 15%-25% of colorectal cancer patients presenting with liver metastasis at the time of diagnosis. Additionally, 15%-25% of patients may experience liver metastasis after curative resection of colorectal cancer, indicating a relatively high incidence rate.
Liver metastasis is also the primary cause of death in colorectal cancer patients, with 80-90% of initial liver metastases being unresectable. Untreated patients with liver metastasis have a median survival period of only 6.9 months, and the 5-year survival rate for unresectable cases is less than 5%, indicating that fewer than 5 out of 100 individuals can survive for 5 years. However, after complete resection of liver metastases, the median survival period for patients can extend to 35 months, and the 5-year survival rate increases to 30-57%. Therefore, early detection and early curative treatment of liver metastases in colorectal cancer are crucial!
Diagnosis of Colorectal Cancer Liver Metastasis
 
1. Colonoscopy
This procedure can determine the presence of tumors in the colon, and tissue samples can be taken for pathological biopsy to confirm whether it is malignant or benign. This examination is essential, especially for patients with multiple liver tumors.
 
2. Chest/Abdomen/Pelvic Contrast-Enhanced CT or Liver Ultrasonography
Patients with liver metastasis inconclusive through contrast-enhanced CT may require additional MRI scans, especially for those suspected of having rectal cancer.
 
3. CEA and CA199 Tests
Tumor markers for colorectal cancer; elevated levels may indicate colorectal cancer to a certain extent.
 
4. Liver Biopsy
When liver metastases cannot be conclusively diagnosed, a biopsy of the liver lesions can be performed to determine the nature of the tumors.
 
5. PET-CT
When necessary, PET-CT can be conducted to clarify the overall extent of metastasis throughout the body.
Treatment of Colorectal Cancer Liver Metastasis
 
The primary treatment modalities for colorectal cancer liver metastasis include the resection of the primary tumor and metastatic lesions (either synchronously or in staged procedures), preoperative neoadjuvant therapy, or postoperative adjuvant therapy (systemic chemotherapy ± targeted drugs). Individualized treatment plans are formulated based on the specific conditions of each patient.
 
For liver metastatic lesions where surgical resection is challenging, minimally invasive interventions, hepatic artery embolization and infusion, various ablation therapies, and recently developed NanoKnife treatments can be employed. 
 
Under the leadership of Professor Wu Aiguo, the Director of Medical Oncology Department, our hospital has successfully completed various gastrointestinal tumor surgeries, including radical surgeries for right-sided colon cancer, left-sided colon cancer, rectal cancer, and reoperations for postoperative tumor recurrence. Additionally, we have conducted resections, ablations, hepatic artery infusion chemotherapy for liver metastases, along with the recent introduction of NanoKnife treatment. We also provide preoperative neoadjuvant and postoperative adjuvant treatments for colorectal cancer.
 
Furthermore, for patients with intra-abdominal metastasis of colorectal cancer, our hospital has implemented intraperitoneal hyperthermic chemotherapy, offering comprehensive and one-stop solutions for the treatment of colorectal cancer liver metastasis and intra-abdominal peritoneal, mesenteric, and omental metastasis.
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