Liver metastases of other indications

Locoregional treatment of liver metastases has been developed especially for tumors that give liver-limited metastases. For all the tumors types and especially for the less usual that are presented in this chapter, the aim is to increase the amount of the drug delivered to the tumor and to decrease systemic toxicity. On the other hand, locoregional treatment in these specific settings may help to increase the activity of the drug especially for rather orphan tumors such as melanoma and pancreatic cancer for instance. Another aim is to fight against the appearance of resistance to systemic treatment (pancreatic carcinoma, breast cancer). In aggressive diseases such as pancreatic carcinoma and melanoma, it is obvious that the indications of locoregional treatment directed to the liver should not be proposed if there is any suspicion of extrahepatic disease. This requirement is not mandatory in tumors such as breast carcinoma in which the prognosis may be linked to liver involvement. In these tumors, liver locoregional treatment could be at least considered even if there is extrahepatic disease when the liver metastases are able to rapidly shorten the survival of the patients.