Liver Metastases: Biology, Diagnosis and Treatment PDF
Preview Liver Metastases: Biology, Diagnosis and Treatment
Liver Metastases Biology, Diagnosis and Treatment Springer London Berlin Heidelberg New York Barcelona Budapest Hong Kong Milan Paris Santa Clara Singapore Tokyo O.J. Garden, J.G. Geraghty and D.M. Nagorney (Eds) R.A. Audisio and H.S. Stoldt (Associate Eds) Liver Metastases Biology, Diagnosis and Treatment With 43 figures, 18 in colour Springer Dr. O.J. Garden Professor of Hepatobiliary Surgery, Department of Surgery, University of Edinburgh, Royal Infirmary, Lauriston Place, Edinburgh EH3 9YW, UK Dr. J.G. Geraghty Consultant Surgeon, Professorial Department of Surgery, Nottingham City Hospital, Hucknall Road, Nottingham NG5 IPB, UK Dr. D.M. Nagorney Professor of Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, MN 55905, USA Associate Editors Dr. R.A. Audisio Deputy Director of General Surgery, European Institute of Oncology, Via Ripamonti 435, 20133 Milan, Italy Dr. H.S. Stoldt Consultartt Surgeon, Department of Surgical Oncology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy British Library Cataloguing in Publication Data Liver metastases: biology, diagnosis and treatment 1. Liver metastases 2. Liver metastases - Diagnosis 3. Liver metastases - Treatment I. Garden, 0 James II. Geraghty, J.G. III. Nagorney, D.M. 616.9'94'36 ISBN-13:97S-1-4471-150S-3 e-ISBN-13:97S-1-4471-1506-9 DOl: 10.1007/97S-1-4471-1506-9 Library of Congress Cataloging-in-Publication Data Liver metastases: biology, diagnosis, and treatment 1 O.J. Garden, J.G. Geraghty, and D.M. Nagorney (eds.). p. cm. Includes bibliographical references and index. ISBN-13:978-1-4471-1508-3 (alk. paper) 1. Liver metastasis. 1. Garden, O. James. II. Geraghty, J.G. (James G.), 1955-. III. Nagorney, D.M. (David M.), 1950-. [DNLM: 1. Liver Neoplasms - secondary. 2. Liver Neoplasms - diagnosis. 3. Liver Neoplasms - therapy. 4. Neoplasm Metastases. WI 735 L7848 1998] RC280.L5L5855 1998 616.99' 436-dc21 DNLM/DLC for Library of Congress 97-52056 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic repro- duction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. © Springer-Verlag London Limited 1998 Softcover reprint of the hardcover 1st edition 1998 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other phar- maceuticalliterature. Typeset by EXPO Holdings, Malaysia 28/3830-543210 Printed on acid-free paper Contents 1 Introduction Martin A. Adson .............................................................................................. 1 2 The Natural History of Metastases to the Liver Mark J. Leiser and David M. Nagorney ......................................................... 7 3 The Biology of Liver Metastasis Robert Radinsky and Isiah J. Fidler ............................................................... 19 4 Staging and Prognostic Factors Leandro Gennari, Roberto Doci and Paola Bignami .................................... 37 5 Diagnosis of Liver Metastasis Doris N. Redhead and Edward Leen .............................................................. 45 6 Surgical Resection Franfois Payne and Bernard Nordlinger ....................................................... 65 7 Laparoscopic Surgery and Liver Metastasis Timothy G. John, K.K. Madhavan and O. James Garden .............................. 81 8 Liver Transplantation for Hepatic Metastases Hauke Lang, Karl Jilrgen Oldhafer, Hans Jilrgen Schlitt and Rudolf Pichlmayrt ........................................................................................... 99 9 Cryotherapy and Other Ablative Procedures Howard. M. KarpofJ, Yuman Fong and Leslie H. Blumgart.......................... 109 10 Systemic Therapy Roberto Labianca, Giuseppe Dallavalle, M. Adelaide Pessi and Giuseppina Zamparelli ................................................................................... 123 11 Regional Infusion Therapy Riccardo A. Audisio, H. Stephan Stoldt and James G. Geraghty................... 141 vi Contents 12 Radiotherapy Carlo Greco and Bruce D. Minsky .................................................................. 153 13 Gene Therapy for Primary and Metastatic Cancer to the Liver M. Wayne Flye and Katherine Parker Ponder ............................................... 161 14 The Role of Nuclear Medicine in the Treatment of Liver Metastases Marco Chinol and Giovanni Paganelli........................................................... 177 15 Palliative Care Vittorio Ventafridda, Alberto Sbanotto and Ruth Burnhill.......................... 189 Index ............................................................................................................................... 203 Contributors Adson, Martin A. Fidler, Isiah J. Professor of Surgery Emeritus Professor and Chairman, Mayo Medical School Department of Cell Biology 200 First Street Southwest University of Texas Rochester MD Anderson Cancer Center Minnesota MN 55905 1515 Holcombe Boulevard, Box 173 USA Houston Texas 77030 Bignami, Paola USA Istituto Nazionale Tumori Via G. Veneziana 1 Flye, M. Wyne 20133 Milano Professor of Surgery, Italy Molecular Microbiology and Immunology Blumgart, Leslie H. Washington University School of Medicine Department of Surgery, Hepatobiliary Service Suite 5103, One Barnes Hospital Plaza Memorial Sloan-Kettering Cancer Center St Louis 1275 York Avenue Missouri MO 63110 New York NY 10021 USA USA Fang, Yuman Burnhill, Ruth Department of Surgery, Hepatobiliary Service Palliative Care Program Memorial Sloan-Kettering Cancer Center European Institute of Oncology 1275 York Avenue Via Ripamonti 435 New York NY 10021 20141 Milano USA Italy Garden, o. James Chinol, Marco Professor of Hepatobiliary Surgery Division of Nuclear Medicine University Department of Surgery European Institute of Oncology Royal Infirmary Via Ripamonti 435 Edinburgh EH3 9YW 20141 Milano UK Italy Gennari, Leandro Dallavalle, Giuseppe Istituto Clinico Humanitas Medical Oncology Via Manzoni 56 Ospedale S Carlo Borromeo 20089 Rozzano (Mi) ViaPio II, 3 Italy 20153 Milano Italy Geraghty, James G. Consultant Surgeon Doci, Roberto Professorial Department of Surgery Istituto Clinico Humanitas Nottingham City Hospital Via Manzoni 56 Hucknall Road 20089 Rozzano (Mi) Nottingham NG5 IPB Italy UK viii Contributors Greco, Catlo Minsky, Bruce D. Department of Radiation Oncology Department of Radiation Oncology European Institute of Oncology Memorial Sloan-Kettering Cancer Center Via Ripamonti 435 1275 York Avenue 20141 Milano New York Italy NY 10021 USA John, Timothy G. Consultant Surgeon Nagorney, David M. Department of Surgery Professor of Surgery North Hampshire Hospital Division of General Surgery Basingstoke Mayo Clinic Hants RG24 9NA 200 First Street Southwest UK Rochester Minnesota MN 55905 Karpoff, Howard M. USA Department of Surgery, Hepatobiliary Service Memorial Sloan-Kettering Cancer Center Nordlinger, Bernard 1275 York Avenue Hopital Ambroise Pare New York NY 10021 Chirurgie generale digestive et oncologique USA 9 avenue Charles De Gaulle 92104 Boulogne Cedex Labianca, Roberto France Medical Oncology Ospedale S Carlo Borromeo Oldhafer, Karl Jiirgen Via Pio II, 3 Klinik fUr Abdominal und 20153 Milano Transplantationschirurgie Italy Medizinische Hochschule Hannover Carl Neuberg Str. 1 Lang,Hauke 30625 Hannover Klinik fUr Abdominal und Germany Transplantationschirurgie Medizinische Hochschule Hannover Pagnelli, Giovanni Carl Neuberg Str. 1 Division of Nuclear Medicine 30625 Hannover European Institute of Oncology Germany Via Ripamonti 435 20141 Milano Leen, Edward Italy Consultant Radiologist Department of Radiology Pessi, M. Adelaide Glasgow Royal Infirmary Medical Oncology Queen Elizabeth Building Ospedale S Carlo Borromeo Alexandra Parade Via Pio II, 3 Glasgow G31 2ER 20153 Milano UK Italy Leiser, Mark J. Pichlmayr, Rudolf Assistant Professor of Surgery (Died August 29, 1997) Department of Surgery Professor of Surgery University of Texas Klinik fur Abdominal und Southwestern Medical Center Transplantationschirurgie 5323 Harry Hines Boulevard Medizinische Hochschule Hannover Dallas TX 75235-9156 Carl Neuberg Str. 1 USA 30625 Hannover Germany Madhavan, Krishnakumar Consultant Surgeon Department of Surgery Royal Infirmary Edinburgh EH3 9YW UK Contributors ix Radinsky, Robert Stoldt, H. Stephan Department of Cell Biology Consultant Surgeon University of Texas Department of Surgical Oncology MD Anderson Cancer Center European Institute of Oncology 1515 Holcombe Boulevard, Box 173 Via Ripamonti 435 Houston 20141 Milano Texas 77030 Italy USA Ventafridda, Vittorio Redhead, Doris N. WHO Collaborating Center Consultant Radiologist for Cancer Control and Palliative Care Department of Radiology European Institute of Oncology Royal Infirmary Via Ripamonti 435 Lauriston Place 20141 Milano Edinburgh EH3 9YW Italy UK Giuseppina, Zamparelli Sbanotto, Alberto Medical Oncology Palliative Care Program Ospedale S Carlo Borromeo European Institute of Oncology ViaPio II, 3 Via Ripamonti 435 20153 Milano 20141 Milano Italy Italy Schlitt, Hans-/iirgen Klinik fur Abdominal und Transplantationschirurgie Medizinische Hochschule Hannover Carl Neuberg Str. 1 30625 Hannover Germany Introduction Martin A. Adson 1 - I have framed the introduction to this text by shared only a small part of my mentor's surgical looking hackward to two personal events: my surgi- experience with the liver (which on no day involved cal introduction to the liver and my more recent resection of the huge tumours that I was then asked retirement from it. These benchmarks gave focus to to see). Also, at that time, like most young surgeons, my reading, placed progress in frames of time, and I did not feel ordinary and was extraordinarily offer some historical perspective. The value of reluctant to leave in place a tumour that might rea- reflection about the treatment of liver metastases sonably be taken out when nothing else useful might forty years ago may be questioned by readers who be done. That attitude was reinforced by close asso- now study liver metastases at the molecular level; ciation with surgical pathologists whose expert but it is not good to be isolated from the past, and interpretation of frozen sections was clinically others who intervene grossly with new instruments enhanced by frequent visits with surgeons in the may find understanding in surgical memory. These operating room. I recall asking Drs. David Dahlin reflections are personal, but less personal than and Malcolm Dockerty for help with a surgical metastatic cancer which must be treated in the judgement when they said simply: 'If you leave that context of personal relationships - with patients and in, don't you think it will grow?' That whimsical colleagues. remark was offered within a very special relation- My surgical training was completed in 1955 but ship. I had studied surgical pathology with both of was incomplete 'liver-wise' because most of my them and we all knew that their knowledge and teachers had little need and less inclination to tres- experience was just one aspect of surgical judgment. pass on the liver. However, my mentor, Dr. John That was particularly true when surgeons and McMaster Waugh, often took out things that others surgical pathologists were dealing with a 'new' left behind. In 1963, a year after his untimely death, clinico-pathological entity for which the benefits of his personal experience with resection of hepatic surgical treatment were unknown. Surgically invit- metastases from a variety of visceral cancers was ing hepatic metastases, once clinically obscure, were published. Operative mortality was 4% and 20% of made newly visible by evolving diagnostic technol- his 25 patients lived for five or more years. ogy, newly vulnerable to changing surgical attitudes, Despite that favourable report, such efforts did and more often referred after discovery during not become the conventional wisdom of that day, another surgeon's operation. because such operations were not convenient and in Most surgeons removed small superficial lesions ordinary hands their risk was unacceptable. safely. However, the reported risk of removing Nevertheless, John Waugh had established an insti- larger lesions was formidable; and the unreported tutional precedent and obligation to patients risk of this endeavour was unacceptable. In this cir- referred for management of metastatic tumours of cumstance, a so-called general surgeon had to the liver. I found myself in a lonely gap between decide whether to become a liver surgeon or not. In institutional and personal obligation. John Waugh the early 1960s, that transition involved two major was no longer here; I had been surgically and meta- concerns: one strategic (what should be done), and physically close to him; and none of my colleagues the other tactical (what could be done). It was seemed to be much interested in the liver. I had difficult to make a case for the removal of any
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