Metastases are cancers that “spread” from one organ to another. The liver is one of the most common places where cancers spread to. The origin of the cancer (the “primary”) may be from inside the abdomen or gastrointestinal tract, such as colon, rectum, stomach, esophagus, pancreas, gallbladder, bile duct, small intestines; or from outside the abdomen, such as melanoma and breast.

Biologically speaking, the most common type of cancer metastasizing to the liver are adenocarcinomas, cancers arising from gland-forming tissue, such as bowel. Other types include neuroendocrine tumours and sarcomas.

The investigations and treatment for liver metastases are complex and require multidisciplinary discussion. Options are wide-ranging and may include surgical resection, ablation, embolization, radiotherapy, transplantation, and chemotherapy. Various factors to consider include the cancer origin, the biological type, the extent of cancers in the liver, the stage of the disease (where else has the cancer spread to?), the time course of the cancer, what other cancer treatment the patient may have already had, and the age and fitness of the patient. In addition, in the recent years, there have been newer developments in chemotherapy or chemotherapy-like treatment that target specific cellular pathways involved in cancer growth, or specific genetic mutations which influence how a cancer responds to treatment. These may be considered in selected patients. Many of these treatment are available to all New Zealand residents through the public hospital system, while some are not, and are only offered in the private sector.

While metastases do generally reflect a more advanced stage of disease (stage 4 by most classifications) and therefore are difficult to cure, modern advances in surgery and medicine have lead to better and better outcomes, with some cases achieving long term remission or even cure.