Surgical Resection as a Metastatic Colon Cancer Treatment
A surgical oncologist would be consulted based on the investigation findings and patient’s fitness to decide if the liver metastatic is “respectable" or “nonresectable". The benefits of surgery resection as a metastatic colon cancer treatment must be more than the risk of the procedure. Up to 30 percent of patients may be cured if metastases in the liver can be successfully removed. Favorable prognostic factors for these patients are:
1) Well differentiated tumor
2) Absence of vascular invasion
3) Tumors size less than 5 cm in diameter
Chemotherapy may be given to shrink the tumor size in facilitating the surgical resection. This is done before the surgery though the metastasis may be confined to the liver. Additional chemotherapy combination is usually recommended after surgery as well: FOLFOX (Oxaliplatin+5-FU+leucovorin), FOLFIRI (Irinotecan+5-FU+leucovorin), XELOX ( Oxaliplatin+ Capecitabine).
Chemotherapy can be administered via hepatic intra arterial method, directly into the liver as compared to the usual intravenous administration. However, the effect for this hepatic intra arterial method is unclear.