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Division of
Endocrine and Oncologic Surgery
Cancer Metastatic to the Liver
Doug Fraker
Dr. Fraker
Dr. Doug Fraker
R. DeMatteo
Dr.Giorgos Karakousis
Dr. Karakousis
Dr. Robert Roses
Dr. Roses

A majority of patients with cancer metastasis to the liver are treated with chemotherapy alone. However, a notable exception to this is metastatic colorectal cancer. The liver is often the first and may be the only site of spread in patients with colorectal cancer. Surgery to remove these cancers is most effective and gives the best opportunity for cure. Other surgical approaches, which offer potential for improvement in survival and cure include ablative techniques such as radiofrequency ablation along with direct infusion of chemotherapy to the liver via hepatic artery infusion pumps.

The program for treatment of patients with metastatic colorectal cancer to the liver integrates the most advanced treatments in a multidisciplinary approach. Our surgeons work in collaboration with radiologists and our oncologists to identify patients who will benefit from liver-directed surgical treatment.

Liver Resection
Our surgeons integrate the newest techniques in evaluation of the liver with intraoperative ultrasonography along with techniques for hemostasis to limit blood loss and allow for removal of the smallest portions of liver possible in order to resect the tumors. Patients who are candidates for liver resection, based on careful screening and staging, have the best potential for survival.

Ablative Therapies
Patients who are not candidates for removal of their tumors (secondary to locations or number) are candidates for in situ ablation of their tumors. Most commonly, this involves radiofrequency ablation, which allows for destruction of the tumor cells with heat while maximally preserving the native liver and function.

Hepatic Artery Infusion Chemotherapy
Hepatic artery infusion chemotherapy can be used in patients who undergo removal of their tumors or radiofrequency ablation as a separate therapy. This treatment involves the placement of a catheter into the blood vessel which goes directly to the liver. This allows for the direct treatment of liver tumors with infusion of chemotherapy. This type of treatment results in lower systemic symptoms such as diarrhea, nausea, vomiting, and fatigue while allowing for a better treatment response in the tumor.

Minimally Invasive Surgical Techniques
The Division of Surgical Oncology is pioneering minimally invasive surgical techniques for the treatment of liver metastasis. With the use of laparoscopy and laparoscopic ultrasound ablative therapy such as radiofrequency ablation and hepatic artery infusion chemotherapy can be delivered without the morbidity of open laparotomy. These techniques allow for complete evaluation of the liver and treatment of all metastatic tumors, and they limit postoperative pain and recovery.

Inpatient Facilities:
Hospital University of Pennsylvania (HUP)

Office Visit Locations:
Perelman Center for Advanced Medicine, West Pavilion, 4th Floor
Rena Rowan Breast Center, Abramson Cancer Center
Perelman Center for Advanced Medicine, West Pavilion, 3rd Floor

Making an Office Visit Appointment:
215-615-5858 or 800-789-PENN

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