Liver cancer metastasis, which means the primary tumor is already advanced. Even with a number of active treatment, the prognosis is still not satisfactory. So, how to prevent the occurrence of liver cancer, it? Key to preventing the occurrence of liver cancer, primary cancer is early diagnosis and early treatment, early discovery of the primary cancer, timely treatment of curative measures, such as surgical resection, For tumor stage later, a partial transfer of radical surgical resection than patients, but should be supported by chemotherapy, radiotherapy and other measures to maximize the kill cancer cells, so as to achieve the purpose of reducing relapse and metastasis. Of course, the hospital's medical standards, the surgeon's surgical skills, a direct impact on the radical cancer surgery (tumor resection is clean), but also for tumor recurrence and metastasis in the future would have a negligible impact.
Most liver cancer, primary cancer occurred before signs and symptoms produced by the majority element of symptomatic liver metastases only in the clinical examination was found. The clinical manifestations of liver metastases and primary liver cancer were similar to, but slower development than the latter, the symptoms are mild. In addition to clinical manifestations of primary tumor, liver, more than minor or obvious symptoms such as abdominal or liver discomfort, pain, stomach cancer can cause bloating oppression, loss of appetite, nausea and vomiting, patients mainly to the late the right upper quadrant pain, hepatomegaly, anemia, yellow disease and ascites. Yellow Fever typically be found in the terminal early, but lymphoma and other blood-lines of spread of liver metastases can occur because of compression and early yellow bile duct disease.
Laboratory tests: The most common abnormal biochemical tests for the serum alkaline phosphatase increased, often at the same time with lactic dehydrogenase, glutamic acid increased the enzyme transferred skin. There may be more extensive liver metastases hypoalbuminemia, anemia, elevated bilirubin and transaminase. Check the significance of tumor markers in hematologic questions below. Liver cancer, multiple liver tumors is the most common imaging feature (B over, CT, NMR, etc.). B-in the "bull's-eye sign" is a typical example of metastatic liver cancer.
Surgery is likely the only way to cure metastatic liver cancer. Surgical indications from metastatic liver cancer appears early detection of liver cancer, the patient is still good general condition, the function of important organs is still within the normal range, is still able to tolerate surgery, there is no extrahepatic metastases cases the surgical removal of liver metastases is possible. The key to early detection of liver metastases after resection of the primary tumor is closely followed up, at least every 3 months to do a comprehensive review, including: blood routine biochemistry, serum tumor markers and imaging B ultrasound, chest X-ray inspection necessary to do CT, and sometimes the primary tumor recurrence or metastasis elevated serum tumor markers are often advanced to imaging (such as that placeholder) evidence.
Check Hematology significance of tumor markers: identification of liver occupying the nature of the primary cancer or metastasis is cancer; identify the source of metastatic carcinoma; tumor resection follow-up indicators. For liver cancer is concerned, different from primary liver cancer, AFP CAFP) is usually negative, but the stomach, pancreas, ovary and testicular cancer in the liver can be seen slightly elevated. 50% -75% of cases of liver cancer with serum carcinoembryonic antigen CCEA) levels were significantly increased, mainly seen in the gastrointestinal, lung and liver metastases of breast cancer who. Ca-19.9, and Ca-72.4 increased more common in primary tumors in the digestive tract, Ca-153 increased more common in breast cancer, Ca-125 increased more common in ovarian cancer.
For the primary tumor and liver metastases after surgical removal of tumor markers in serum was reduced or normal patients were followed up during the rise of tumor markers, and showed a trend of continuous increase, the tips of tumor recurrence or new metastasis appears.
Primary liver cancer disease progression is rapid, the more obvious symptoms, often associated with chronic viral hepatitis (hepatitis B, hepatitis C, etc.) and cirrhosis, liver cancer is more common complications of the tumor was solitary nodule also were more common, a fetal eggs CAFP) and other tumor markers were positive, but sometimes have to rely on identification of ultrasound guided liver biopsy, especially for those with negative AFP. When the histological examination revealed polygonal cells in the central core living, nuclear inclusion bodies within the cytoplasm of malignant cells separated by sinusoidal capillaries, bile retention, groups of tumor cells surrounded by endothelial cells performance, suggesting that the original onset rather than secondary liver cancer. Liver cancer is relatively slow progress in contrast, mild symptoms, a clinical manifestation of primary tumor, and less cirrhosis, fewer complications, cancer often has multiple diffuse, AFP often not high, blood alkaline phosphatase increased. Found that the primary cancer and the presence of intrahepatic metastasis, confirmed by histopathology the same source, is the basis for the final diagnosis of metastatic liver cancer.
A body 859 from 24 patients with multi-center retrospective study, a rigorous selection cases of colorectal cancer liver metastases underwent surgical resection, postoperative 5-year survival rate was 33% survival rate after 5 years for the disease of 21%. More colorectal liver metastases after resection of 50% 5-year survival reported.
Prognosis after resection of liver metastasis of many factors, through the review of clinical data and research, currently considered the following factors after resection of metastatic liver cancer prognosis is more precise:
(1) the number of metastases: Wagner reported that the transfer of single leaf solitary metastatic liver cancer resection patients, the median survival was 21 months, and many stoves are only 15 months. Goslin reported 3 or fewer liver metastases after resection of liver metastases in patients median survival was 24 months, and four or more only 10 months.
(2) after resection of primary tumor diagnosis and liver disease-free interval between: Haghes retrospective studies have shown that disease-free survival between patients more than 12 months of liver resection of metastatic liver cancer patients survive 5 years after 42%, no disease-free survival of less than 12 months between the 5-year survival rate of only 2%.
(3) adequate tumor-free surgical margin: the so-called tumor-free margin is the removal of liver metastases during surgery need to be removed when the part of the normal liver, to ensure that no residual tumor margin to ensure that radical surgery. Cady reported no larger than 1 cm tumor margin resection of liver cancer patients after 5-year survival rate was 60%, negative margins and no tumor margin less than 1 cm in 5-year survival rate was 30%, while the positive margin 5-year survivors of those dollars.
In addition, there extrahepatic tumor recurrence, extrahepatic metastases (even if it can resection), tumor differentiation is low, when the primary tumor resection with lymph node metastasis had a poor prognosis.