• The relation between Colorectal cancer and liver metastasis
  • Farnaz Gheisari,1,*
    1. Master student of microbiology , Department of microbiology , Jahrom Branch , Islamic Azad University , Jahrom , Iran


  • Introduction: Colorectal cancer (CRC) is a widespread malignant tumor globally, ranking third in cancer incidence. Various factors contribute to the development of colorectal cancer. Increased risk is associated with a personal or family history of cancer, colon polyps, inflammatory bowel diseases, diabetes mellitus, or cholecystectomy. Lifestyle choices such as being overweight or obese, lack of physical activity, smoking, excessive alcohol intake, and poor dietary habits also elevate the risk. Additionally, factors like gut microbiome composition, age, gender, race, and socioeconomic status play roles in influencing colorectal cancer risk. Liver metastases significantly contribute to the mortality of CRC patients, with the liver being the primary site for CRC metastasis.
  • Methods: Colorectal cancer (CRC) significantly contributes to global tumor-related morbidity and mortality. Liver metastases (LM) develop in roughly half of CRC patients during the disease course. Surgical resection stands as the sole treatment offering potential cure and long-term survival, with 5- and 10-year survival rates approximately at 40% and 25%, respectively. In specific patient cohorts, up to 97% of ten-year survivors remained disease-free following colorectal liver metastases (CRLM) resection. However, upfront surgery is feasible for only a small fraction of patients. Metastasis, notably to the liver and lungs, significantly contributes to CRC-related mortality. Surgical resection of colorectal liver metastases (CRLMs) and colorectal pulmonary metastases (CRPMs) stands as the sole potentially curative treatment. However, patients with unresectable metastatic CRC (mCRC) might find benefit in locoregional therapies like radiofrequency ablation and stereotactic radiotherapy.
  • Results: Colorectal cancers (CRCs) typically metastasize to the liver via the portal venous circulation, whereas cancer cells from non-gastrointestinal origins tend to spread through the hepatic artery and systemic circulation. Both sources of hepatic blood flow merge in the liver sinusoids, where blood perfuses the liver parenchyma before returning to the systemic circulation via the centrilobular veins. Upon entering the liver sinusoids, circulating CRC tumor cells undergo metastasis through four dynamic and overlapping phases.
  • Conclusion: After curative treatment, metastasis remains a significant challenge and is the primary cause of CRC-related deaths. The liver, connected directly to the colorectal region through the portal vein system, is the most frequent site of distant metastasis in CRC, benefitting from a rich blood supply. Additionally, factors such as the primary tumor's location and histological type contribute to liver metastasis. Approximately 25% of CRC patients may present with synchronous colorectal liver metastases (CRLM), with an additional 50% developing CRLM during the disease progression. Standard treatment approaches for colorectal liver metastasis (CRLM) include curative resection and chemotherapy.
  • Keywords: Colorectal -Liver - Cancer - Metastasis -Tumor