Liver Metastases (Secondary Liver Cancer): Surgery

Surgery to remove liver tumors is a challenging procedure that requires a team of experienced doctors who focus exclusively on this type of operation. Many of the major blood vessels running to and from the heart pass behind or through the liver, essentially connecting these organs. In addition, the liver can tear easily and bleeds profusely when injured.

However, the safety of this type of surgery has improved dramatically over recent years as a result of better imaging and operative techniques, and increased experience on the part of practitioners.

Our surgeons operate on several hundred patients with liver metastases annually, and along with interventional radiologists have developed and refined several of the techniques that produce better results — including approaches that minimize blood loss and the need for transfusions during an operation.

Our team also has led the way in showing that surgical removal of a limited numbers of tumors in the liver is associated with increased long-term survival (measurable in years). In particular, liver surgery for people with colorectal cancer that has spread to the liver has become safe and effective even in cases of somewhat extensive metastatic disease, with unprecedented long-term survival rates.

Minimally Invasive Surgery

We have developed and continue to enhance minimally invasive techniques, both laparoscopic and robotic, as well as imaging approaches used during operations, to expand the suite of treatment options available to people with liver metastases.

When possible, we use liver-sparing techniques that leave more of the healthy liver intact, reducing the risk of complications and the need for the liver to regenerate (grow back).

Undergoing laparoscopic surgery instead of traditional surgery, in selected patients, can significantly reduce the time it takes to recover. In this procedure, surgeons insert a thin, lighted tube with a camera on its tip through a tiny incision in the patient's abdomen. They then guide surgical instruments through the laparoscope to remove tumors or, in some cases, part of the liver.

Increasingly, our surgeons also use robotic surgery to remove part of the liver in selected patients.

In people who have liver metastases from tumors that have spread from the colon or rectum, our surgeons are often able to remove tumors in both places during the same operation, rather than performing two separate surgeries. This is usually done when the liver tumors are limited in size and number.

Often done in combination with chemotherapy, this approach has been shown to significantly reduce complications and recovery time.(1),(2) Studies suggest that up to half of all people who undergo surgery to remove colorectal liver metastases survive for at least five years.

  1. Ito K, Govindarajin A, Fong Y, Surgical treatment of hepatic colorectal metastasis, The Cancer Journal 2010 16(2)
  2. Martin R, Paty P, Fong Y, et al. Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis, Journal of the American College of Surgery 197(2), 2003: 233-41