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Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2025; 17(10): 110026
Published online Oct 27, 2025. doi: 10.4254/wjh.v17.i10.110026
Clinicopathological insights and management of liver metastases: Current advances and future perspectives
Noura A A Ebrahim, Thoraya A Farghaly, Ahmed Abdo El-Sherif, Ahmed M Fahmy, Moamen O Othman, Neveen S Tahoun, Omnia Mohamed Korany, Aya Arafat, Reham Oreaba, Soliman M A Soliman
Noura A A Ebrahim, Ahmed M Fahmy, Department of Oncologic Pathology, National Cancer Institute, Cairo University, Cairo 11796, Al Qahirah, Egypt
Thoraya A Farghaly, Department of Chemistry, Faculty of Science, Umm Al-Qura University, Makkah 21955, Saudi Arabia
Ahmed Abdo El-Sherif, Soliman M A Soliman, Department of Chemistry, Faculty of Science, Cairo University, Cairo 12613, Al Qahirah, Egypt
Moamen O Othman, Kasr Alainy Faculty of Medicine, Cairo University, Cairo 11562, Al Qahirah, Egypt
Neveen S Tahoun, Cytopathology Unit, Department of Oncologic Pathology, National Cancer Institute, Cairo University, Cairo 11796, Al Qahirah, Egypt
Omnia Mohamed Korany, Department of Medical Oncology, National Cancer Institute, Cairo University, Cairo 11796, Al Qahirah, Egypt
Aya Arafat, Department of Chemical and Clinical Pathology, Kasr Al-Aini faculty of Medicine, Cairo University, Cairo 11562, Al Qahirah, Egypt
Reham Oreaba, Department of Surgical Oncology, National Cancer Institute, Cairo University, Cairo 11796, Al Qahirah, Egypt
Author contributions: Ebrahim NAA and Soliman SMA led the conceptual design and framework development of the review article, were primarily responsible for defining the manuscript structure, overseeing all stages of the literature review, critically appraising included studies, and synthesizing key findings, drafted the majority of the text, conducted multiple content revisions, handled the integration of clinical and molecular aspects throughout the manuscript, coordinated contributions from all co-authors, supervised figure design, and ensured the scientific accuracy and consistency of the final version; Farghaly TA played a key role in revising the literature review and critically analyzing content related to molecular mechanisms and biochemical pathways; El-Sherif AA, Fahmy AM, Tahoun NS, Korany OM, and Oreaba R provided support in reference verification, figure preparation, and reviewing the clinical and management-related content; Othman MO and Arafat A participated in targeted literature searches, contributed to writing select sections, and assisted in compiling data tables; all authors contributed to reviewing the final draft and approved the completed manuscript for publication.
Supported by UMM Al-Qura University, Saudi Arabia, No. 25UQU4350477GSSR05.
Conflict-of-interest statement: The authors affirm that they have no conflicts of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Soliman M A Soliman, MSc, PhD, Department of Chemistry, Faculty of Science, Cairo University, 1 Gamaa Street, Cairo 12613, Al Qahirah, Egypt. sabdellatif@sci.cu.edu.eg
Received: May 28, 2025
Revised: June 28, 2025
Accepted: September 23, 2025
Published online: October 27, 2025
Processing time: 152 Days and 18.4 Hours
Abstract

Liver metastases are a leading contributor to cancer-related illness and death, occurring far more frequently than primary liver tumors. Their management remains highly challenging due to the complexity of disease behavior and the need for an individualized, multidisciplinary approach. Effective care increasingly relies on integrating sophisticated diagnostic techniques, advanced systemic and locoregional therapies, and molecularly tailored treatment strategies. This review provides an in-depth analysis of the current clinicopathological perspectives on liver metastases. It explores their epidemiology, mechanisms of spread, histological growth patterns, diagnostic imaging advancements, molecular characteristics, and therapeutic interventions. Additionally, it examines the broader implications for patient quality of life (QoL), healthcare costs, and the particular difficulties associated with managing liver metastases in pediatric patients and individuals with rare malignancies. The article outlines the diverse histopathological features and tumor–liver interface growth patterns, emphasizing their prognostic and therapeutic significance. It evaluates contemporary imaging modalities–including magnetic resonance imaging and computed tomography (CT) with hepatocyte-specific agents, positron emission tomography/CT, and contrast-enhanced ultrasound–and highlights the emerging importance of liquid biopsy and molecular profiling in shaping treatment decisions. The review discusses available treatment options such as chemotherapy, targeted agents, immunotherapies, surgical resection, liver transplantation, and various locoregional therapies. Furthermore, it addresses evolving fields like prognostic scoring systems, radiomics, artificial intelligence (AI) applications, and patient–derived organoid and xenograft models. A summary of current clinical trials and translational research initiatives reflects the fast-paced evolution of this field. The management of liver metastases is rapidly advancing, driven by precision oncology principles and collaborative, multidisciplinary care. The integration of molecular diagnostics, novel therapeutic approaches, and cutting–edge technologies–including AI and organoid-based personalized drug testing-is poised to enhance treatment selection, improve clinical outcomes, and support better QoL. These innovations hold the potential to transform the outlook for patients with liver metastases, moving toward more durable disease control in appropriately selected cases.

Keywords: Liver metastases; Histopathological growth patterns; Liquid biopsy; Molecular profiling; Systemic therapy; Locoregional treatment; Artificial intelligence; Radiomics; Organoids; Precision oncology

Core Tip: Liver metastases remain one of the most significant contributors to cancer-related deaths, occurring far more frequently than primary hepatic tumors. This review delivers a thorough overview of current clinicopathological understanding, diagnostic imaging innovations, and evolving treatment approaches for managing liver metastases. It underscores the prognostic relevance of distinct histological growth patterns and the expanding clinical value of liquid biopsy techniques, molecular characterization, and multidisciplinary management strategies. Additionally, the review discusses emerging precision oncology tools-including artificial intelligence, radiomics, and patient-derived organoid models-that are shaping the future of personalized care for patients with metastatic liver disease.