Dr. Jarnagin on Surgical Protocols for CRC That Have Spread Beyond the Liver

William R. Jarnagin, MD, FACS, chief, Hepatopancreatobiliary Service, Benno C. Schmidt Chair, Surgical Oncology, Memorial Sloan Kettering Cancer Center, discusses the surgical barriers in treating patients with colorectal cancer that has metastasized outside of the liver.

The difficulty in treating these patients is not so much a matter of the surgical operation, but whether these sites should be resected. When the cancer has spread to the liver and other sites, the results of surgery on the liver become worse; the risk of recurrence becomes much higher.

Though there are some patients who will benefit from resection of disease in the liver, lymph nodes, and lung, the majority of patients will not see a benefit. Surgeons and medical oncologists have to determine who should have an operation and who should not because once the disease has advanced, the results of surgery in the liver become more difficult to predict.