A Combined Surgical Approach May Be an Option for Some People With Colorectal Cancer That Has Spread to the Abdomen and Liver

Abdominal Cancers Alliance
Jan 2
2 min read

Updated: Jan 12

Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy and Liver Resection is a Treatment Option for Patients With Peritoneal and Liver Metastases From Colorectal Cancer. Authors: Vegar Johansen Dagenborg, Kristoffer Watten Brudvik, Christin Lund-Andersen, Annette Torgunrud, Marius Lund-Iversen, Kjersti Flatmark, Stein Gunnar Larsen, Sheraz Yaqub. Ann Surg. 2024 Nov 1;280(5):745-752. doi: 10.1097/SLA.0000000000006492. Epub 2024 Aug 26. PMID: 39185557; PMCID: PMC11446514.

Treating Colorectal Cancer That Has Spread to the Abdomen and Liver

This research study explored outcomes for people with colorectal cancer that had spread to two places at the same time:

the lining of the abdomen (called the peritoneum), and
the liver.

When cancer spreads to more than one area, treatment decisions can become more complicated. In the past, many doctors believed that having cancer in both the abdomen and the liver meant surgery would be too risky or unlikely to help. This study looked closely at whether that assumption is always true.

What Treatments Were Studied?

Researchers examined outcomes for patients who underwent:

Cytoreductive Surgery (CRS): surgery to remove all visible cancer from the abdomen whenever possible
HIPEC (Heated Intraperitoneal Chemotherapy): heated chemotherapy delivered directly into the abdomen during surgery
Treatment for liver tumors, which included:
- surgical removal of liver tumors,
- ablation (destroying tumors with heat), or
- a combination of approaches

Some patients had liver treatment before CRS-HIPEC, some during the same operation, and others afterward.

What Did the Study Find?

The results were encouraging:

Safety: Patients tolerated the combined treatments well. There were no deaths within 90 days of surgery, and serious complications occurred at rates similar to patients who had CRS-HIPEC without liver involvement.
Survival: On average, patients lived about 4 years (48 months) after CRS-HIPEC. This survival time was comparable to outcomes seen in patients whose cancer had only spread within the abdomen.
Liver Surgery and Risk: Treating liver tumors at the same time as CRS-HIPEC did not increase the risk of major complications, suggesting that combining these treatments can be done safely in carefully selected patients.

Why Is This Important?

This study challenges the long-held belief that colorectal cancer spreading to both the abdomen and liver automatically rules out aggressive surgical treatment.

For carefully selected patients, a combined approach may:

offer meaningful long-term survival,
provide another treatment option beyond chemotherapy alone, and
support a more individualized treatment plan.

What This Means for Patients and Families

Every cancer journey is unique. This research shows that having cancer spread to more than one area does not automatically mean surgery isn’t an option. For some patients, evaluation at a specialized center with experience in CRS-HIPEC and liver surgery may open doors to additional treatment possibilities.

If you or a loved one is facing colorectal cancer with peritoneal and liver involvement, it may be helpful to: