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. "
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