Mr. Wang, who had a successful career, retired early and enjoyed his life, suddenly found out that he had liver cancer. After struggling for a while, I finally found the courage to undergo surgery to remove the liver tumor. Doctors say the prognosis for surgery should be good because of the early detection. However, Mr. Wang is still very worried. Has he really recovered? Can cancer cells metastasize to other organs?

Similarly, Ms. Liu accidentally discovered a 5 cm tumor in her liver during a physical examination in a foreign country five years ago. The local doctors thought it was impossible to operate, but she was worried that she had to go back to China for surgery, and the tumor was successfully removed. After that, she received regular follow-up examinations every six months. . Recently, she felt a dull pain in her back. At first, she didn’t notice it, but the symptoms persisted, so she took an X-ray of her back and found that the bones on her back had been metastasized by cancer cells!

For patients with liver cancer, after surgical resection, will liver cancer recur, or will it metastasize to other organs in the body? It has always been their biggest nightmare.

In the early stage, liver cancer cannot be detected early. Therefore, when liver cancer is discovered, it is mostly in the late stage of liver cancer. The liver cancer is usually very large, the symptoms are obvious, and the survival period is not long. Therefore, even if there is metastasis to other organs, it is of little significance to the patient. .

In recent years, liver cancer can not only be detected early, but also has made great progress in treatment, and the chance of long-term survival is also very high. Therefore, whether liver cancer will metastasize after surgery or other treatments is more and more important for patients and medical staff.

Liver cancer metastases most likely to occur in the lungs

There are two types of liver cancer metastasis: intrahepatic and extrahepatic. Intrahepatic metastases, in which tumors travel through blood vessels in the liver to other parts of the liver, are usually not detected until the tumor has grown larger after a period of treatment. As for the way of extrahepatic metastasis, the most common is through blood metastasis, and a small part is through lymphatic metastasis.

Extrahepatic metastases are most likely to occur in organs such as lungs, bones, adrenal glands, and lymph nodes, which are related to the direction of blood, and a small number of patients will metastasize to the brain. For those who have ruptured liver cancer, the cancer cells are prone to intra-abdominal metastasis.

In the early stage of liver cancer metastasis, there are many asymptomatic

When liver cancer metastasizes to other organs, symptoms may not necessarily appear. Even if some symptoms appear, they are often not specific, so they are often regarded as other diseases and ignored.

For example, if liver cancer metastasizes to the lungs, symptoms such as coughing and wheezing may occur; those metastasized to the bones are mostly manifested by pain, but if the spine is compressed, different symptoms such as paralysis and limb weakness may appear, depending on the location of the compression. However, because cancer cells cause damage to bones, fractures and fractures often occur; for those who metastasize to the lymph nodes, it will cause pain if the nerve is compressed, and the duodenum will bleed. Similarly, those who metastasize to the brain , Also depending on the location of the lesion, symptoms such as headache, bleeding, and even confusion may occur; and if it metastasizes to the adrenal gland, most of them have no symptoms, and must be detected by CT scan or MRI.

Which liver cancers are more prone to extrahepatic metastasis?

Whether liver cancer will metastasize outside the liver has a great relationship with the location and shape of the tumor.

Anatomically, the blood of the hepatic vein returns to the inferior vena cava and then back to the heart, so tumors growing next to the hepatic vein or the inferior vena cava are more likely to metastasize through the heart to the whole body.

Which tumors are prone to intrahepatic metastasis?

The portal vein collects blood from the gastrointestinal tract and enters the liver, and forms dense small branches in the liver, so tumors close to the portal vein can easily metastasize to other places in the liver through the portal vein.

In addition, tumors without capsules and irregular margins are also prone to enter the portal vein and metastasize to other tissues in the liver, or enter the hepatic vein and metastasize to other organs of the body. Therefore, the treatment of tumors close to the portal vein must be as early as possible.

How to diagnose liver cancer metastasis early?

At present, it is impossible to diagnose whether there is a small amount of cancer cells metastasized before surgery, no matter what kind of examination is used. Generally, only the tumor reaches 0.5cm or even more than 1cm can be more clearly diagnosed. Therefore, the best way is to experience long-term discomfort or have If there is a problem, check it more.

Follow-up examinations are mainly based on abdominal ultrasound and alpha-fetoprotein. If the abdominal ultrasound is normal, but the alpha-fetoprotein is elevated, it is likely that there is extrahepatic metastasis.

In addition, since extrahepatic metastases are usually asymptomatic, if you have extrahepatic discomfort, you must inform your doctor as soon as possible so that further examinations can be arranged.

If extrahepatic metastasis is suspected, what tests should be done?

The tests that these doctors usually arrange include: chest X-rays, ultrasounds, CT scans, bone X-rays, and MRIs.

How is extrahepatic metastasis treated?

The treatment of extrahepatic metastases has a lot to do with the physical condition. If the physical condition is good, there will be more options for treatment. Even if extrahepatic metastases occur, if there is one or more, but the location is good or limited to one place, surgical resection is still the best method, but the scary thing is that many extrahepatic metastases are multiple, and resection may be possible at this time. Inappropriate, at this time can only be changed to drugs or other treatments.

There must be no cure for extrahepatic metastasis?

Extrahepatic metastasis does not mean that there is no rescue. Many people can have good results after treatment. There are also many clinical cases with long-term survival. For example, in a patient with liver cancer previously known, the tumor metastasized to the adrenal gland, and then the adrenal gland was removed, and there was no recurrence 5 years after the operation.

In addition, there was also 1 patient whose liver cancer had metastasized to the lungs. There were 3 tumors in the lungs. After one year of re-examination, there were still 3 tumors, which did not increase. Later, the tumors gradually became larger. Because the patient was in good health, he underwent surgery within six months. Three operations, ten years, still very healthy. Another patient with ruptured liver cancer developed abdominal metastases. Since surgery could not be performed, the attending doctor suggested drug treatment. With the help of the doctor’s prescription and follow-up, it has been about 9 years now, and the cancer cells in the abdominal cavity have even disappeared.

Why do tumors grow after liver cancer treatment?

After liver cancer treatment, the liver grows a tumor again. It is difficult to determine whether the original tumor has metastasized or the other cells of the liver have grown by itself, because after the liver is infected with hepatitis B or C, almost every liver cell has a tumor. May turn into cancer cells to become new liver cancer, but the time is not necessarily the same.

According to research, if the tumor is small, the tumor that recurs after surgery or other treatment is usually not the metastasis of the original tumor, but the growth of other liver cells.

However, if the tumor is large or close to the portal vein before treatment, the cancer cells are likely to spread to other parts of the liver by various means before treatment, resulting in intrahepatic metastasis. Since it takes a while for the tumor to grow to be visible on the imaging examination, it is not easy to detect before treatment.

If your feet are numb and weak, you should seek medical treatment as soon as possible.

Weakness of one or both legs of liver cancer patients may be caused by the metastasis of liver cancer to the back spine. It is necessary to seek medical treatment as soon as possible. The liver cancer is easy to transfer to the spine and cause paralysis. However, in the early stage of metastasis, the patient usually does not feel it. Once the tumor grows again and begins to compress the nerve, the feet may become numb and weak, and then one or both feet may be completely paralyzed, and the time from numbness to complete paralysis may be short. Just a few days.

The most important thing is that once the nerve is compressed and causes paralysis, it usually takes only a few hours to recover. At this time, even if the tumor is surgically removed, the paralysis may not be improved. Liver cancer patients must have such vigilance. In case of numbness and weakness in the feet, they must seek medical treatment as soon as possible.

If liver cancer cannot be surgically removed, will it definitely metastasize in the future?

Not necessarily, because in addition to surgical resection, there are arterial embolization, targeted therapy and chemotherapy. The treatment guidelines for liver cancer are that surgical resection, embolization, liver transplantation, etc. are curative treatments. If these treatments cannot be used, the probability of future intrahepatic and extrahepatic metastasis will be relatively high.

Can a liver transplant be done in a patient with liver cancer that has already metastasized?

Not suitable. The current standard for liver transplantation for liver cancer patients is that there must be no distant metastasis (ie, extrahepatic metastasis) and no vascular invasion; for single tumor, the largest diameter must be less than 3-6.5 cm; for multiple tumors, the number of tumors must be less than 3 pieces, the diameter of the largest one must be less than 4.5cm, and the sum of the three pieces must be less than 8cm. Under such standards, the survival rate after liver transplantation will be relatively high, otherwise, even if it is transplanted, it will not help patients much.