Liver Metastasis: Basic aspects, detection and management

397 Pages·1984·11.96 MB·English

by  E. Roos (auth.)

LIVER METASTASIS
DEVELOPMENTS IN ONCOLOGY
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LIVER METASTASIS
Basic aspects, detection and management
edited by
Camelis 1.H. VAN DE VELDE, MD, PhD
Department of Surgery, University Hospital
Leiden, The Netherlands
Paul H. SUGARBAKER, MD
Colorectal Cancer Section, National Institutes oj Health
Bethesda, Maryland, USA
1984 MARTINUS NIJHOFF PUBLISHERS
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
BOSTON I DORDRECHT I LANCASTER
Distributors
for the United States and Canada: Kluwer Academic Publishers, 190 Old Derby
Street, Hingham, MA 02043, USA
for the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited,
Falcon House, Queen Square, Lancaster LAI lRN, England
for all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O. Box 322, 3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
Liver metastasis.
(Developments in oncology)
Proceedings of the International Congress on Hepatic
Metastasis, sponsored by the University Hospital of
Leiden and the National Cancer Institute, USA; and
held in Leiden, May 24-26, 1984.
Includes bibliographies and index.
1. Liver--Cancer--Congresses. 2. Metastasis-
Cilngresses. 3. Cancer invasiveness--Congresses.
I. Velde, Cornelis J. H. van de. II. Sugarbaker,
Paul H. III. International Congress on Hepatic
Metastasis. (1984: Leiden, Netherlands)
IV. Academisch Ziekenhuis (Leiden, Netherlands)
V. National Cancer Institute (U.S.) VI. Series.
RC280.L5L585 1984 616.99'436 84-16621
ISBN-13:978-94-009-6053-4 e-ISBN-13:978-94-009-6051-0
DOl: 10.1007/978-94-009-6051-0
ISBN-13:978-94-009-6053-4 (this volume)
Book Information
This publication is based upon a Boerhaave course organized by the Faculty of
Medicine, University of Leiden, The Netherlands in co-operation with the Na
tional Cancer Institute, Bethesda, Maryland, USA
Copyright
© 1984 by Martinus Nijhoff Publishers, Dordrecht.
Softcover reprint of the hardcover 1st edition 1984
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishers,
Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht,
The Netherlands.
PREFACE
B. CADY
Hepatic met,,'~tasl~S present one of the major therapeutic challenges
of cancer patien: management, for it is the destruction of vital organ
function that makes cancer fatal, not local tumor growth. The process
of tumor cell dislodgement from the primary cancer, their spread through
the lymphatic and hematogenous channels, their lodgement in distant
sites, and their subsequent progressive growth tax our comprehension
a'ld i.-ustrate our therapies. The proceedings of this International
Con,t ss on Hepatic Metastasis address these aspects of metastases to
t:'.>2 _ .ver, and predominatly focus on metastatic colon cancer because
of t ~.s frequency, its prominent hepatic only pattern of spread, and
enticing preliminary data about prevention and control of small sub
.'(ts of the afflicted population. Predictably, the "false technologies"
of Dr. Lewis Thomas that involve surgical, radiotherapeutic and chemo
therapeutic attack on these metastases after elaborate diagnostic
studies take precedence because of the clinical imperatives of sick
patients. This is displayed in the preponderance of papers and in
terest in various diagnostic scanning techniques by means of radio
isotopes, radiographically useful dyes, biochemical markers, interest
in developing accurate staging systems to categorize patients for
therapeutic comparisons, and interest in elaborate, and expensive,
technology to increase the effectiveness of chemotherap~utic agents
that are of limited benefit with simple intravenous administration.
Behind this clinical enthusiasm, however, lies the research to
develop the "true technology," in Thomas' words, that will prevent
such clinical catastrophies as hepatic metastases. The first inkling
of such a "true technology" in liver cancer is the recent development
of hepatitis immunization to prevent subsequent hepatoma in endemic
areas of the world. In hepatic metastases from colon cancer, several
VI
recent articles correlate worse prognosis and by inference liver me
tastases, with perioperative transfusions which induce a state of
relative immunosuppression. Such immunological modulation is bene
ficial in renal transplantation where immunosuppression is necessary,
but is harmful in colon cancer treatment where presumably immune com
petence needs to be intact to prevent implantation and growth of dis
seminated cancer cells. The immunological aspects will clearly be
difficult to unravel as judged by the failure of non-specific immuno
stimulation trials with BCG or MER to improve survival. However, with
such clues as seed may come harvests of research data. The work of
Fidler in defining the hepatic "homing" and lodgement of hematogenously
disseminated cells in animal models and of Folkman in defining angio
neogenesis as a requirement for progressive growth after metastatic
cell lodgement have opened up whole new fields of investigation.
International conferences, as presented in this book, are enormous
stimuli for further work. New directions have been suggested in the
spirited discussion of the workshop sessions of the Congress. Besides
the necessity for laboratory research work, agreements need to be
achieved for a stag~ng system, diagnostic criteria for response,
conditions for conducting and evaluating clinical trials in chemo
therapy, both systemic and regional, and proper criteria for surgical
resection of metastases and even for hepatic transplantation. Inter
national meetings to review progress in hepatic metastases on a regular
basis and to set out new goals in biological understanding and thera
peutic achievement are needed. Hopefully this book will be the first
in a series that measure progress in one of the most devastating com
plications of cancer.
VII
CONTENTS
Preface by B. Cady v
List of Major Contributors IX
Introduction by P.H. Sugarbaker, C.J.H. van de Velde XII
Basic Aspects of Liver Metastasis
1. Invasion of the Liver by Tumor Cells 1
E. Roes
2. The Role of Cell Surface Determinants in Large Cell Lymphoma
Metastasis to Liver 20
G.L. NiCholson
3. Interrelation of Animal Tumor Models to the Clinical Problem of the
Treatment of Hepatic Metastases 36
A. Zwaveling
4. Natural History of Liver Metastases 47
C.B. Wood
5. Methods for Prevention of Metastases in the Perioperative Phase 55
J. Jeekel, Th. Wiggers, R.L. Marquet
Diagnosis and Staging of Liver Metastases
6. The Detection of Liver Metastases by Laboratory Tests 63
M.M. Kemeny
7. Radionuclide Imaging for the Detection of Liver Metastases 83
V.R. McCready, E.K.J. Pauwels
8. Liver Metastasis: The Value of Diagnostic Ultrasound 93
T.H. Shawker
9. EOE-13 and other Contrast Agents for Computed Tomography of the
Liver 102
D.L. Miller
10. Nuclear Magnetic Resonance Imaging of the Liver: Current Status and
Future Possibilities 118
M. Vermess
11. Radiolabeled Antibodies for the Detection of Cancer: New Approaches
to Improve the SensitiVity and Specificity of Immunoscintigraphy 122
J.-P. Mach, J.-Ph. Grob, F. Buchegger, V. von Fliedner,
S. Carrel, J. Pettavel, A. Bischof-Delaloye and B. Delaloye
12. Peritoneoscopy in the Diagnosis of Liver Metastases 132
F.C.A. de Hartog-Jager, E. Gortzak, J.J. Battermann
13. Histopathological and Cytopathological Aspects of Focal Liver
Lesions 139
D.J. Ruiter, G.J. van Steenis
14. Screening for Liver Metastasis in Daily Practice 150
F.J. Cleton
15. The Necessity for Staging Liver Metastases and Standardizing
Treatment-Respons~ Criteria. The Case of Secondaries of Colo-Rectal
Origin 154
J. Pettavel, S. Leyvraz, P. Douglas
VIII
Treatment of Liver Metastases
16. Management of Hepatic Metastases: A General OVerview 169
Ph. S. Schein
17. Adjuvant Chemotherapy for Colo-Rectal Cancer 178
I. Taylor
18. Surgical Therapy of Hepatic Metastases 187
P.H. Sugarbaker, R.T. Ottow, D.A. August
19. Radiotherapy in the Treatment of Liver Metastases 206
P. Thomas
20. Radiological Intervention Techniques in the Percutaneous Treatment
of Liver Metastases 214
S. Wallace, C. Charnsangavej, C.H. Carrasco, W. Bechtel,
K. Wright, C. Gianturco
21. Intra-Arterial Infusion of Cytotoxic Drugs for the Treatment of
Liver Metastases 230
T.J.A. Kuijpers, A.T. van Oosterom, E.H. OVerbosch,
E.A. de Bruijn, M. OUdkerk
New Treatment Modalities
22. Intraperitoneal Chemotherapy. A Possible Role in the Treatment of
Hepatic Metastases 249
J.L. Speyer
23. The Infusaid Pump and Hepatic Regional Chemotherapy 263
P.D. Schneider, P.H. Sugarbaker, F.J. Gianola
24. Receptor-Mediated Endocytosis by Normal and Proliferating
Hepatocytes 278
A. Wolkoff, R.J. Stockert, Ph.S. Schein
25. Isolated Regional Liver Perfusion in the Treatment of Hepatic
Metastases 292
C.J.H. van de Velde, U.R. Tjaden, B.J.L. Kothuis
26. The Use of Microspheres in the Treatment of Liver Metastases 313
J.G. McVie, J.M.V. Burgers, C. Hoefnagel, E. Tomlinson
Surgical Techniques in the Management of Hepatic Metastases
27. Techniques of Hepatic Surgery for Metastatic Cancer 324
P.H. Sugarba~er, R.T. Ottow
28. Technique of Hepatic Infusion Chemotherapy 339
P.H. Sugarbaker, P.D. Schneider
29. The Isolated Liver Perfusion Technique for High-Dose Chemotherapy
of Metastases from Colo-Rectal Cancer. Two years 'Clinical
Experience 346
K.R. Aigner, J.C. Tonn, H. Walther, K.H. Link, K. Schwemmle
30. Methodoloqy in the Clinical Study of Hepatic Metastases 358
C.J.H. van de Velde, C.H.N. Veenhof, P.H. Sugarbaker
Index of Subjects 375
LIST OF MAJOR CONTRIBUTORS
K.R. Aigner, M.D., Department of Surgery, Justus-Liebig-University,
Klinikstrasse 29, 63 Giessen, West Germany.
B. Cady, M.D., Professor of Surgery at the New England Deaconess
Hospital, Harvard Medical School, Boston, MA 02115, U.S.A.
F.J. Cleton, M.D., Ph.D., Professor of Medicine, Chairman Dept. of
Clinical Oncology, University Hospital, 2333 AA Leiden, The Netherlands.
F.C.A. den Hartog Jager, M.D., Dept. of Medicine, The Netherlands
Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
J. Jeekel, M.D., Ph.D. Professor of Surgery, Chairman Dept. of Surgery,
University Hospital Dijkzigt, Dr. Molewaterplein 40, 3015 GD Rotterdam,
The Nether lands.
M.M. Kemeny, M.D., Senior Surgeon, City of Hope National Medical Center,
1500 East Duarte Road, Duarte 91010, California, U.S.A.
T.J.A. Kuijpers, M.D., Dept. of Diagnostic Radiology, University
Hospital, 2333 AA Leiden, The Netherlands.
J.P. Mach, M.D., Professor at the Ludwig Institute for Cancer Research,
Ch. des Boveresses, CH-1066 Epalinges, Lausanne, Switzerland.
V.R. McCready, M.D., Consultant Nuclear Medicine, The Royal Marsden
Hospital, Downs Road, Stutton, Surrey SM2 5PT, Great Britain.
J.G. McVie, M.D., Dept. of Hedicine, The Netherlands Cancer Institute,
Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
D.L. Miller, M.D., Senior Radiologist, Dept. of Diagnostic Radiology,
National Institutes of Health , Bethesda, Maryland 20205, U.S.A.
G.L. Nicolson, Professor of Cancer Research, Head of the Dept. of
Tumor Biology, M.D. Anderson Hospital, 6723 Bertner Avenue, Houston,
Texas 77030, U.S.A.
A.T. van Oosterom, H.D., Ph.D., Dept. of Clinical Oncology, University
Hospital, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.
E.K.J. Pauwels, Ph.D., Dept. of Diagnostic Radiology, Div. of Nuclear
Medicine, University Hospital, Rijnsburgerweg 10, 2333 AA Leiden,
The Netherlands.
J. Pettavel, M.D., Professor at the Dept. of Surgery, 10, Avenue de la
Gare, Lausanne University Hospitals, 1003 Lausanne, Switzerland.
E. Roos, Ph.D., Division of Cell Biology, The Netherlands Cancer
Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
x
D.J. Ruiter, M.D., Ph.D., Dept. of Pathology, Faculty of Medicine,
University of Leiden, 2333 AA Leiden, The Netherlands.
Ph.S. Schein,M.D., F.R.C.P., Research and Development, Smith Kline
and French Laboratories, 1500 Spring Garden Street, P.O. Box 7929,
Philadelphia 19101, U.S.A.
P.D. Schneider, M.D., F.A.C.S., Senior Surgeon, National Institutes
of Health, Bethesda, Maryland 20205, U.S.A.
T.H. Shawker, Chief Ultrasound Dept., Diagnostic Radiology, National
Institutes of Health, Bethesda, Maryland 20205, U.S.A.
J.L. Speyer, M.D. Dept. of Medicine, New York University Medical Center,
550 First Avetlue, NewoYork, N.Y. 10016, U.S.A.
P.H. Sugarbaker, M.D., Head of the Colorectal Cancer Section, Surgery
Branch, National Institutes of Healt, Bethesda, Maryland 20205, U.S.A.
G.J. van Steenis, M.D., Dept. of Clinical Cytology, University Hospital,
Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.
I. Taylor, M.D., Ch.M., F.R.C.S., Professor of Surgery, University
Surgical Unit of the Southampton General Hospital, 'F'-level,
Tremona Road, Southampton S01 6HU, Great Britain.
P. Thomas, M.D., Ph.D., Professor of Radiotherapy, Dept. of Clinical
Oncology, University Hospital, Rijnsburgerweg 10, 2333 AA Leiden,
The Netherlands.
C.B.N. Veenhof, M.D., Ph.D., Division of Medical Oncology, Dept. of
Medicine, Medical Center of the University of Amsterdam, Meibergdreef 9,
1105 AZ Amsterdam, The Netherlands.
C.J.H. van de Velde, M.D., Ph.D. Dept. of Surgery, University Hospital,
Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands
M. Vermess, M.D., Associate Chief Radiologist, Dept. of Diagnostic
Radiology, National Institutes of Health, Bethesda, Maryland 20205, U.S.A.
S. Wallace, M.D., Professor of Radiology, Dept. of Diagnostic Radiology,
M.D. Anderson Hospital and Tumor Institute, 6723 Bertner Avenue,
Houston, Texas 77030, U.S.A.
A.W. Wolkoff, M.D., Associate Professor of Medicine, Liver Research
Center, Albert Einstein College of Medicine, 1300 Morris Park,
Bronx, New York, N.Y. 10461, U.S.A.
C.B. Wood, F.R.C.S., Senior Lecturer in Surgery, Royal Postgraduate
Medical School, Hammersmith Hospital, Ducane Road, London W12 OHS,
Great Britain.
A. Zwaveling, M.D., Ph.D., Professor of Surgery, Chairman Dept. of
Surgery, University Hospital, Rijnsburgerweg 10, 2333 AA Leiden,
The Netherlands.