How is dx and tx of metastatic neoplasms of liver?

DIAGNOSIS Increased ALP, GGT, lactic dehydrogenase (LDH), AST, and ALT (nonspecific). Metastases will enhance on contrast CT . Intraoperative ultrasound with liver palpation is the most sensitive diagnostic tool TREATMENT Surgical resection (metastasecomy or hepatectomy) Most common resectable tumors are colon, endocrine, melanoma. Contraindications to surgery: extrahepatic disease Prognosis: colon cancer has 45% 5-year survival with radical resection. We have to be aggressive in the indication and resection Hepatic artery chemotherapy (metastatic colon cancer only). Radiofrequency ablation or cryotherapy for unresectable lesions if all can be addressed and extrahepatic disease is absent. Monitor treatment with carcinoembryonic antigen (CEA)levels for colon cancer; CT scanning. Prognosis: colon cancer has 45% 5-year survival with radical resection.