Dr. Spaggiari on Surgical Strategies to Improve Liver Remnants in CRC With Liver Metastases

Mario Spaggiari, MD, transplant surgeon, Division of Transplantation, University of Illinois Health, discusses surgical strategies to improve liver remnants in colorectal cancer (CRC) with liver metastases.

The liver remnant, or how much liver is left after surgery, is an important aspect of a successful surgical resection for patients with CRC and liver metastases, Spaggiari says. As such, different surgical approaches can be utilized to increase the size of non-malignant liver in preparation for surgery, including portal vein embolization. With this strategy, the liver can be restaged after 2 to 3 weeks following portal vein embolization and then the patient can be reassessed for surgery.

Additionally, aggressive surgical procedures that can increase the size of the liver in a shorter period can be utilized if the patient requires more immediate surgery, Spaggiari explains. For example, utilizing surgery in combination with interventional radiology allows for a patient to undergo a large surgery with a significantly increased liver remnant within a period of 7 to 15 days, Spaggiari concludes.