Is there nothing that can be done once a tumor has metastasized to the liver? Many tumors can metastasize to the liver, and liver metastases mean that the tumor has progressed to an advanced stage. There are many such patients currently receiving systemic intravenous chemotherapy for a simple reason: surgery considers the tumor to be advanced and surgery may not prolong the patient’s survival; and most liver metastases are not very sensitive to radiotherapy. So these patients are referred to gastroenterology. The benefit of systemic intravenous chemotherapy is the high concentration of drugs throughout the body, and for patients with metastases in multiple sites throughout the body intravenous chemotherapy is a treatment that can prolong the patient’s life. Patients who have received intravenous chemotherapy know that chemotherapy drugs enter the body from the upper limb veins or subclavian veins. Chemotherapy drugs first enter the heart (right atrium, right ventricle), then enter both lungs from the heart, then return from the pulmonary veins to the heart (left atrium, left ventricle), and then fight out of the aorta. At this time, part of the drugs enter the head, part of the drugs enter both upper limbs, and the rest of the drugs continue to go down the body, and when the drugs reach the abdominal When the drug reaches the abdominal aorta, only then does part of the drug enter the liver via the abdominal artery, while the rest of the drug is shunted to the stomach, pancreas, spleen, both kidneys, intestines and both lower extremities, etc. Assuming that the drugs are evenly distributed in the body, only 1/6 of the total amount of drugs enter the liver, while the remaining 5/6 are distributed to other parts of the body, causing side effects such as bone marrow suppression, nausea and vomiting. Is there a way to inject chemotherapy drugs directly into the liver? Yes, there is a minimally invasive interventional therapy. Minimally invasive interventions use a needle to puncture the femoral artery at the root of the thigh and place a catheter (about the thickness of a pencil lead) into the hepatic artery, with a drug delivery device attached to the back end of the catheter. For example, if 150 mg of chemotherapy is given intravenously, about 25 mg of the drug enters the liver, whereas if 100 mg of the drug is given from the hepatic artery through interventional therapy, the liver receives 100 mg of the drug, which means that although we only use 100 mg of the drug, the liver receives four times the amount of the drug than in intravenous chemotherapy. Therefore, we can reduce the dose of systemic drug and increase the local dose of tumor, which can improve the efficacy of tumor treatment and reduce the systemic toxic side effects. The advantages of this treatment method are: high local drug concentration in the tumor and low drug concentration in other parts of the body, so the toxic side effects of patients are mild. The disadvantage is that tumors at other sites (outside the area of drug administration) may progress. This treatment can be applied to most patients with metastatic liver cancer, and of course to patients with primary liver cancer. Of course, the premise is that the tumor is more sensitive to chemotherapy, like gallbladder cancer and cholangiocarcinoma which are less sensitive to chemotherapy have poorer efficacy. Many patients with advanced malignant tumors have liver metastases, and the main cause of death for most of them is liver metastases. Therefore, control of liver metastasis is a major means to prolong the survival of patients.