Colorectal Cancer: Prevention and Management of Metastatic Disease

Table 1

Comparison and contrast of liver metastases and peritoneal metastases from colorectal cancer.

	Liver Metastases	Peritoneal Metastases
Mechanism of dissemination	Portal vein	Peritoneal space
Mode of progression	Expansion of a parenchymal mass	Exfoliation
Metastatic efficiency	Low	High
Incidence with primary resection	20%	10%
Incidence with diagnosis of recurrence	50%*	60%*
Response to modern systemic chemotherapy	60%	30%
Benefit from reoperative surgery requires an R-0 resection	Yes	Yes
Preventive strategies in existence	No	Yes

∗The high incidence of peritoneal metastases seen with recurrent cancer may be in large part preventable. No known treatment to prevent liver metastases is currently available.