Liver metastases are a frequent and often fatal occurrence in cancer patients, particularly those with malignancies of the gastrointestinal (GI) tract. While recent improvements in surgical techniques and a more aggressive approach to resection of liver metastases have improved long term survival for some patients, most patients with hepatic metastases still succumb to their disease. To improve these dismal statistics, a better understanding of the biology of liver metastasis, particularly the early stages that can be targeted for prevention, is essential. Once cancer cells enter the liver, several different scenarios may occur. The cancer cells may be immediately destroyed by local defence mechanisms, they may enter a state of dormancy as solitary cells and never produce a metastasis, initiate a short-lived process of proliferation that is aborted before a metastasis is established or actively proliferate to form macrometastases. The chapters in Part I of this book provide insight into the cellular/molecular mechanisms that determine which of these scenarios prevails. Written by experts researchers in the filed of metastasis, these chapters provide state-of-the art reviews on the cellular and molecular processes that impact the early stages of the metastatic process. The unique microenvironment of the liver, its various anatomical, cellular and molecular features and the impact they have on metastasis are highlighted. In addition, the role of inflammation (pre-existing and tumor-induced), host innate and adaptive immune responses, cytokines, chemokines, growth factors and the unique molecular signatures of metastatic tumor cells are reviewed with an underscoring of the translational implications of the current state of knowledge. Against this background, the chapters in Part II of the book provide critical reviews on major aspects of the clinical management of hepatic metastases. These include imaging strategies, surgical and chemotherapeutic treatment approaches and the use of targeted biological therapeutics such as anti-angiogenic drugs as treatment modalities. By combining information on biological and clinical aspects of liver metastasis, this volume will serve as an excellent resource for scientists, clinicians, clinician/ scientists and trainees in the domains of oncology, surgical oncology, hepatobiliary physiology and radiology.

One reason for failure to cure solid tumors by surgery appears to be the impossibility of controlling metastases that are present but latent at the time of operation. This failure is a common clinical experience with aggressive neoplasms. but it is not always appreciated in tumors with longer survival times. e. g .• breast and colon cancer. In addition. recent evidence indicates that after resection of a primary tumor micrometas tases from it might be enhanced by suppression of immune and reticu loendothelial functions of the host. Other factors, such as increase of coagulability and stress in the perioperative period, can also promote tumor growth. The development of new metastases might be facilitated by cells forced into the circulation during operative manipulations. Such events could be important for the outcome of treatment and it is suggested that preventive measures should be directed to this systemic component of solid tumors. Radical surgery can reduce the number of tumor cells to a subclinical 3 6 stage (10 to 10 cells) in which chemotherapy might be more effective than in advanced stages. Chemotherapy, on the other hand, might aggravate the surgical morbidity by influencing the wound healing pro cess, by decreasing the immune response, and/or by toxicity to the bone marrow and to the gastrointestinal tract, for example.

Colorectal cancer is the third most commonly diagnosed condition in oncology, affecting around 1.23 million individuals per year, according to recent statistics. Of these patients, about 50% will develop liver metastases and approximately 20% will present a stage IV disease at diagnosis. These statistics make colorectal liver metastases (CLM) an issue of major importance in current oncology. The area of CLM is subject to great and continuous advances, as its pathophysiologic mechanisms are better understood and more therapeutic and surgical options are developed. Consequently, all professionals involved with the diagnosis, treatment and follow up of CLM should be kept up to date with the latest advances on the field, to provide high standard medical care to their patients. This book is designed to present the state-of-the-art in CLM management and, in doing so, to review the current evidence on CLM, discussing all important topics in the field. Coverage is broad and comprehensive, encompassing introductory topics (history, definitions, epidemiology, etc.), basic science subjects (molecular biology, genetics, dissemination process, etc.) and practical clinical topics (tumor behavior, diagnosis, drug therapy, radiation therapy, surgery, ablation, multidisciplinary teams, etc.). Although comprehensive on the coverage and selection of topics, each chapter is concise and objective, dissecting topics in a practical and direct format. Evidences and recommendations are included. Chapters display a brief introduction of the common knowledge, go straight to the detailed revision of the most recent years of the literature, and end with practical closing observations. This book is a tool for professionals (general and cancer surgeons, HPB surgeons, clinical oncologists, gastroenterologists and medical residents) and interns who search for a qualified and reader friendly revision on topics concerning Colorectal Cancer Liver Metastases.

Introduction to Cancer Metastasis provides, in one place, an overview of organ-specific cancer metastasis and the most common sites of cancer metastasis. Through specific chapters on individual primary cancers, their metastasis, and chapters on common metastatic sites, this volume comprehensively informs readers about the broader knowledge base in cancer metastasis. The process of metastasis is particularly responsible for making cancer so lethal. This volume explores both metastasis from sites of origin and common metastatic sites, thus increasing understanding of both perspectives. - Includes basic biology and translational approaches to organ-specific cancer sites - Provides readers with information on emerging therapeutic targets for cancer metastasis - Contains contributions from leading researchers around the globe

Colorectal cancer is the third most common cancer worldwide, and in many parts of the western world, it is the second leading cause of cancer-related deaths. This book covers colon cancer metastasis from the most fundamental aspects to clinical practice. Major topics include physiopathology, genetic and epigenetic controls, cancer initiating cells, epithelial-mesenchymal transition, growth factors and signalling, cell adhesion, natures of liver metastasis, angiogenesis and lymphangiogenesis, inflammatory response, prognostic markers, sentinel node and staging, and finally diagnosis and treatment. Each chapter has been contributed by leaders in the field. A key feature is that it connects with a large readership including students, fundamentalists and clinicians. Another specific feature of the book is that the chapters are written in a didactic and illustrative fashion. These characteristics coupled with the choice of the topics and authors, makes this book a reference in the field. It represents an essential acquisition for medical libraries, clinicians as well as medical and graduate students.

This book covers all liver tumors and lesions that clinically and radiologically mimic liver tumors. It provides readers with a comprehensive overview of this complex and rapidly evolving field. All aspects of surgical pathology are addressed, supplemented by detailed presentations of the lesions’ cell-biologic and molecular features. In addition, the methods employed for diagnosis and diagnostic algorithms are discussed. It appeals to pathologists and hepatologists and serves as an invaluable aid to diagnosis.The field of liver tumors and tumor-like lesions in adults and children has experienced tremendous advances in recent years. Specifically, the recognition of novel entities, deepened insights into known tumors, and refinement of classifications have necessitated continual updates and reappraisals. In addition, previous understanding of hepatic carcinogenesis and tumor progression has been transformed by the very rapid evolution of our understanding of cell biology, genomics, signaling pathways, cell interactions, and mechanisms of invasion and spread of hepatic tumor cells. These general pathology issues must be combined with surgical pathology if a comprehensive understanding of liver tumor pathology is to be achieved.

Contemporary Management of Metastatic Colorectal Cancer: A Precision Medicine Approach summarizes current knowledge and provides evidenced-based practice recommendations on how to treat patients with metastatic colorectal cancer. The book presents topics such as pre-operating imaging, the use of molecular markers in treatment decisions, neoadjuvant therapy, synchronous colorectal liver metastasis, and minimally invasive approaches. In addition, it discusses immunotherapy, targeted therapies and survivorship. This is a valuable resource for practitioners, cancer researchers, oncologists, graduate students and members of biomedical research who need to understand more about novel treatments for colorectal cancer metastasis. - Summarizes contemporary data in the workup and treatment of patients with metastatic colorectal cancer - Discusses novel patient-centric personalized approaches surrounding the management of such cancer types - Presents evidenced-based recommendations for precision care among patients with metastatic colorectal cancer