Objective:

The discussion explores evolving management of primary and metastatic liver tumors, including surgical and liver-directed approaches.

Approach:

• Participants: Robert Redfield III, MD, discusses treatment with hepatobiliary surgical oncologists Reed Ayabe, MD, and Zeljka Jutric, MD.
• Topics: The discussion covers robotic and laparoscopic liver surgery, staged and repeat resections, hepatic arterial infusion chemotherapy, portal vein embolization, liver regeneration, and multidisciplinary planning.

Key Findings:

• The discussion states that advanced liver cancer or colorectal liver metastases do not necessarily rule out surgical treatment.
• Hepatic arterial infusion chemotherapy is discussed as a way to downstage initially unresectable liver metastases.
• Portal vein embolization and future liver remnant optimization are discussed as techniques to prepare for complex liver surgery.
• The discussion describes potentially curative treatment options for select patients with advanced disease, including some with stage IV colorectal cancer.

Interpretation:

The discussion describes minimally invasive surgery, liver-directed therapies and multidisciplinary planning in the evolving management of selected patients with primary or metastatic liver tumors.

Limitations:

• The supplied context provides a discussion description but no study methods, patient-level data or comparative outcome estimates.

Conclusion:

The discussion covers surgical and liver-directed approaches, including minimally invasive resection, hepatic arterial infusion chemotherapy and portal vein embolization, for selected patients with primary or metastatic liver tumors.

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