Resection and embolization in the management of secondary hepatic tumors

The management of hepatic metastases either by means of hepatic resection or by hepatic artery embolization is reviewed. Hepatic resection is of value either as a palliative or potentially curative measure, especially in secondary deposits arising from primary sites in the colorectum. Approximately 26% of patients with primary colorectal cancer will have hepatic metastases at diagnosis and, of these, some 5–10% will be amenable to resection. Untreated, all patients die within 5 years, but resection of solitary metastases would appear to offer a 20% chance of 5‐year survival. Better results have been obtained with resection carried out for smaller lesions. Major resections carried out for large lesions are not as successful. Hepatic artery embolization is useful in a wide variety of secondary hepatic deposits, not only to treat local symptoms but also to ameliorate the systemic effects produced by secondary deposits arising from primary endocrine tumors. Controlled clinical studies allowing comparison of the results of tumor embolization with those of other forms of palliative therapy or of symptomatic treatment are now necessary.