Therapeutic Strategies in Primary and Metastatic Liver Cancer

Primary and metastasizing malignant carcinoma of the liv­ er represent a challenge to both the diagnostician and the therapist. For this reason, it appears a worthwhile task to review the current status of knowledge about the treatment of primary and metastasizing tumors of the liver. The ques­ tion is whether modem diagnostic methods and new thera­ peutic concepts can help to improve the prospects of treat­ ment. Of particular interest is the role played by therapeu­ tic procedures directly involving the liver. Thus, it is equally important to discuss the pathophysiological and pharmacological bases for a modem therapy concept as it is to consider diagnostic issues and possible definitions of stages of progression. Therapeutic concepts comprise sys­ temic therapy and organ-related therapeutic methods, in­ cluding surgical resection, changes in the blood supply, re­ gional selective chemotherapy, and other localized or regional, highly specialized forms of therapy. This survey of the various possibilities in the field is meant too to stimulate further scientific research, given that methods of treatment are as yet by no means stan­ dardized, but are still in the stage of clinical research, where experimental models can find an application. The only well-established operative procedure is surgery on the isolated liver tumor. In this area, specialized techniques and various intraoperative procedures are discussed. There is a wealth of information available on all the top­ ics covered.