Zane KE, Cloyd JM, Mumtaz KS, Wadhwa V, Makary MS. Metastatic disease to the liver: Locoregional therapy strategies and outcomes. World J Clin Oncol 2021; 12(9): 725-745 [PMID: 34631439 DOI: 10.5306/wjco.v12.i9.725]
Corresponding Author of This Article
Mina S Makary, MD, Assistant Professor, Attending Doctor, Director, Department of Radiology, The Ohio State University Wexner Medical Center, 4th Floor Faculty Office Tower, Columbus, OH 43210, United States. mina.makary@osumc.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Sep 24, 2021; 12(9): 725-745 Published online Sep 24, 2021. doi: 10.5306/wjco.v12.i9.725
Metastatic disease to the liver: Locoregional therapy strategies and outcomes
Kylie E Zane, Jordan M Cloyd, Khalid S Mumtaz, Vibhor Wadhwa, Mina S Makary
Kylie E Zane, Mina S Makary, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Jordan M Cloyd, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Khalid S Mumtaz, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Vibhor Wadhwa, Department of Radiology, Weill Cornell Medical Center, New York City, NY 10065, United States
Author contributions: Zane KE, Cloyd JM, Mumtaz K, Wadhwa V, and Makary MS performed the literature review, wrote the manuscript, prepared the tables, made the requested revisions, and provided final approval of the final version of the manuscript to be published.
Conflict-of-interest statement: There are no conflict of interests associated with any of the authors of this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mina S Makary, MD, Assistant Professor, Attending Doctor, Director, Department of Radiology, The Ohio State University Wexner Medical Center, 4th Floor Faculty Office Tower, Columbus, OH 43210, United States. mina.makary@osumc.edu
Received: April 2, 2021 Peer-review started: April 2, 2021 First decision: June 7, 2021 Revised: June 14, 2021 Accepted: August 31, 2021 Article in press: August 31, 2021 Published online: September 24, 2021 Processing time: 168 Days and 6.5 Hours
Abstract
Secondary cancers of the liver are more than twenty times more common than primary tumors and are incurable in most cases. While surgical resection and systemic chemotherapy are often the first-line therapy for metastatic liver disease, a majority of patients present with bilobar disease not amenable to curative local resection. Furthermore, by the time metastasis to the liver has developed, many tumors demonstrate a degree of resistance to systemic chemotherapy. Fortunately, catheter-directed and percutaneous locoregional approaches have evolved as major treatment modalities for unresectable metastatic disease. These novel techniques can be used for diverse applications ranging from curative intent for small localized tumors, downstaging of large tumors for resection, or locoregional control and palliation of advanced disease. Their use has been associated with increased tumor response, increased disease-free and overall survival, and decreased morbidity and mortality in a broad range of metastatic disease. This review explores recent advances in liver-directed therapies for metastatic liver disease from primary colorectal, neuroendocrine, breast, and lung cancer, as well as uveal melanoma, cholangiocarcinoma, and sarcoma. Therapies discussed include bland transarterial embolization, chemoembolization, radioembolization, and ablative therapies, with a focus on current treatment approaches, outcomes of locoregional therapy, and future directions in each type of metastatic disease.
Core Tip: Locoregional percutaneous catheter-directed approaches have been associated with better tumor response, improved disease-free and overall survival, and decreased morbidity in metastatic disease to the liver compared to standard treatment. This review explores recent advances in liver-directed therapies for metastatic liver disease from primary colorectal, neuroendocrine, breast, and lung cancer, as well as uveal melanoma, cholangiocarcinoma, and sarcoma. Therapies discussed include bland transarterial embolization, chemoembolization, radioembolization, and ablative therapies, with a focus on current treatment approaches, outcomes of locoregional therapy, and future directions in each type of metastatic disease.
