Confirm resectability
Confirm whether a case considered unresectable can be operated on with high-complexity techniques.
Reviewed by Prof. Fabrizio Panaro · Updated: April 30, 2026
Specialty
Surgery for liver metastases
At Quenet-Torrent Institute we treat liver metastases with high-complexity surgical strategies that combine resection, liver-sparing techniques and systemic treatment, with curative intent.
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Clinical summary
Liver metastases (mainly of colorectal origin) are treated with liver resection combined with perioperative chemotherapy, with 5-year survival of 40-50% after complete resection. At Quenet-Torrent Institute (Barcelona · Madrid), the team of Dr. Quenet and Dr. Torrent, led by Prof. Panaro, uses ALPPS and two-stage hepatectomy for initially unresectable cases.
What are liver metastases?
Liver metastases are secondary tumors that arise when cancer cells from other organs spread to the liver. The most common come from colorectal cancer, but they can also originate in the breast, lung, pancreas, stomach and other tumors.
The liver is often affected because of its rich blood supply. Unlike what happens in other organs, liver metastases can be treated with curative intent through surgery when they are confined to the liver.
Surgery for liver metastases can significantly increase survival, especially for those of colorectal origin, where long-term cure rates exceed 40%.
Symptoms of liver metastases
Liver metastases are often detected without symptoms, during follow-up of the primary tumor with imaging or blood tests. While the liver still works normally, the patient may feel perfectly well, which is why regular oncological follow-up is what allows early diagnosis.
When symptoms appear, the most common are pain or discomfort in the right upper abdomen, abdominal swelling, weight and appetite loss, progressive tiredness and jaundice. In some cases there may be fever or night sweats. Any of these signs in a patient with a history of cancer should prompt a medical visit without delay to rule out spread to the liver.
Causes and risk factors of liver metastases
The cause of liver metastases is always a primary tumor in another organ that spreads cancer cells to the liver through the bloodstream or lymphatic system. Colorectal cancer is the most common origin, followed by tumors of the breast, pancreas, stomach and lung and neuroendocrine tumors, among others.
The risk of developing liver metastases depends on the type of primary tumor, its stage at diagnosis and its molecular biology. Some tumors are more likely to spread to the liver for anatomical reasons, as with colorectal cancer, whose portal venous drainage goes directly to this organ. Proper diagnosis and follow-up of the primary tumor allow metastases to be detected at a treatable stage.
Why ask for a second opinion on liver metastases?
A second opinion can find surgical options in a case considered inoperable.
Assess two-stage surgery
Assess complex strategies such as two-stage surgery, ALPPS or portal vein embolization.
Evaluate conversion chemotherapy
Evaluate whether chemotherapy can make an unresectable tumor operable.
Consider combined treatments
Consider ablation, stereotactic radiotherapy or other locoregional therapies.
Many patients considered inoperable can benefit from an assessment at a specialized center.
How do we treat liver metastases?
Surgical treatment is the only option with curative potential for liver metastases.
Parenchyma-sparing hepatectomy
Resection of the tumor while keeping as much healthy liver tissue as possible.
Two-stage surgery
For bilobar tumors, allowing the liver to regenerate between operations.
ALPPS
A technique that achieves rapid liver growth for initially unresectable cases.
Resection combined with ablation
A combination of surgery with tumor destruction by radiofrequency or microwaves.
The strategy is tailored to the number, size and location of the metastases.
Our technology
Technology for liver metastasis surgery
These are the techniques we use to plan and perform the surgery.
3D liver volumetry
Precise calculation of the functional liver remnant after resection.
Intraoperative ultrasound
Detection of hidden lesions and guidance for the resection.
Portal vein embolization
Growth of the future liver remnant before surgery.
Radiofrequency/microwave ablation
Tumor destruction complementary to resection.
PET-CT
Precise staging to rule out disease outside the liver.
WHY CHOOSE US?
Experience in complex cases
Quenet-Torrent Institute treats liver metastases with teams specialized in high-complexity liver surgery.
Experience in complex cases
We focus on advanced and metastatic cancer, with techniques such as two-stage hepatectomy, ALPPS or resection combined with ablation, which not every center offers.
Comprehensive, multidisciplinary approach
Surgeons, oncologists, radiologists, nutritionists and psychologists review your case together.
Research
We follow the published scientific evidence and review our protocols when new data appear.
Surgical technology
We have 3D liver volumetry, intraoperative ultrasound, portal vein embolization, ablation and PET-CT to plan and perform each resection.
Personal, close care
We explain each step of the treatment and answer your questions throughout the process.
Our team
Liver metastasis specialists
Surgeons on the team who treat liver metastases.
Dr. François Quenet
Oncological surgeon
View doctor: Dr. François Quenet"Surgeon with expertise in gastrointestinal and hepatobiliary tumors and in highly difficult operations."
Dr. Juan José Torrent
Oncological surgeon
View doctor: Dr. Juan José Torrent"Specialist in gynecological tumors, peritoneal carcinomatosis and complex oncological surgery."
Frequently asked questions about liver metastases
Answers to the most common questions about diagnosis, treatment and prognosis.
Can liver metastases be cured?
Yes, in many cases. Surgery for liver metastases of colorectal origin achieves five-year survival above 40%, and some of those patients are cured. The condition is to remove all the disease while leaving enough healthy, working liver.
How many metastases can be operated on?
There is no maximum number. What decides is not how many lesions there are, but whether they can all be removed while leaving enough healthy, working liver. Patients with more than ten metastases have been operated on successfully, while a single badly placed lesion can be impossible to reach. What counts is the distribution, not the count.
What if the metastases are in both lobes?
Involvement of both lobes does not rule out surgery. There are strategies such as two-stage hepatectomy, portal vein embolization or ALPPS, which allow one side to be treated first, waiting for the liver to grow, and the resection to be completed afterwards. Resection and ablation can also be combined.
Is chemotherapy needed before surgery?
In many cases, yes. Prior chemotherapy shrinks the metastases, makes resection easier and shows how the disease behaves before surgery. It has a limit: prolonging it too much damages the liver, so the timing of surgery must be decided by the multidisciplinary board.
How long does recovery take?
The hospital stay is usually 5 to 10 days and full recovery takes between 4 and 8 weeks, depending on the size of the resection. If further chemotherapy is planned, it resumes once liver function has recovered. Discharge is decided by progress, not by a fixed timeline.
What should I do if I have been told it is inoperable?
Ask for a second opinion at a center with experience in complex liver surgery. Many cases labeled inoperable can in fact be treated with techniques such as portal vein embolization, two-stage hepatectomy or a combination of resection and ablation. Resectability depends on the team assessing it.
Is ablation an alternative to surgery?
It can be an alternative for small lesions or in patients who cannot tolerate a resection. Above all it is a complement: in many operations one lobe is resected and the lesions in the other are treated by ablation, preserving more healthy liver. The decision depends on size and location.
Can metastases come back after surgery?
Yes, recurrence is common, but it does not mean the end of surgical options. In many patients a second liver resection can be performed with results similar to the first. That is why follow-up with imaging and tumor markers during the first years is so important.
Where can I receive this treatment safely?
At centers with proven experience in oncological liver surgery and enough case volume. It is worth asking whether the team routinely performs major resections and whether it has interventional radiology for techniques such as portal vein embolization. That combination is what widens the surgical options.
Where to treat liver metastases?
We operate in two private hospitals in Spain. The same medical team treats you in Madrid and in Barcelona, with the same surgical and oncological protocols.
Madrid
Memorial Publio Cordón Hospital
Private hospital in Pozuelo de Alarcón with a multidisciplinary team specialised in digestive surgical oncology.
View Memorial Publio Cordón Hospital
Barcelona
Centro Médico Teknon
Private hospital in Barcelona where the team performs high-complexity surgical oncology.
View Centro Médico Teknon
Real cases
Patients treated by the Quenet Torrent team
Real testimonies from patients treated by our team in high-complexity surgical oncology.
Debra's case
66-year-old English woman with advanced ovarian cancer and peritoneal metastases. Treated with cytoreduction + HIPEC, she is now disease-free.
Read the full caseRosario (Charo)'s case
73-year-old patient with advanced cancer treated with chemotherapy and high-complexity surgical oncology, with good survival and quality of life.
Read the full caseFelipe's case
A mistaken diagnosis of terminal colon cancer that a second opinion revealed to be pseudomyxoma peritonei, treatable with cytoreductive surgery and HIPEC.
Read the full caseSantiago's case
Diagnosed with widespread peritoneal carcinomatosis and considered inoperable. After complete cytoreduction with HIPEC, today his is a story of survival.
Read the full case
Verified reviews
See on Google
4.5/5
What our patients say
L
4 weeks ago
5/5
Wonderful surgical team, among the best out there. Dr. Torrent (expert in peritoneal carcinomatosis) is an exceptional surgeon and an even better person. His coordinator is super kind, fast and efficient. The personal care is excellent and so are the results. This is of vital importance for cancer patients.
K
5 months ago
5/5
In the public healthcare system they gave my father a maximum of one year to live. They only offered him chemo and no hope, said it was impossible, that nothing could be done. He had several tumors inside the peritoneal sac with metastases. A year and a half later he is clean, completely cured. His latest PET scan came back clean. We are very happy. Thanks to Dr. Torrent and his team. THANK YOU.
M
A year ago
5/5
Excellent professionals, especially Dr. Torrent, attentive at all times to the patient (my wife), operated for peritoneal pseudomyxoma. They helped us with all our needs since we came from outside Barcelona. Thank you Elisabeth. We are very grateful to Quenet Torrent Institute, thank you for everything.
P
2 years ago
5/5
I am a 63-year-old patient. They detected adrenal gland cancer and told me there was nothing to be done. I sought a second opinion and they told me about the Quenet Torrent team, specialists in complex operations. Dr. Torrent, from the first moment, told me they could operate. They operated and removed a large tumor mass. I spent a week in the ICU and a month on the ward. Every day he came morning and evening, no matter Saturday or Sunday. Never throw in the towel. I am happy to have found these professionals who gave me my life back. Thank you.
I
3 years ago
5/5
Many thanks for your attention. Dr. Torrent always attentive, involved and decisive. The reception staff very pleasant and always offering the best option. 100% RECOMMENDED. THANK YOU.
M
5 years ago
5/5
Dr. Torrent helped me make the best decision at a difficult moment. I think he is a great professional and a person capable of accompanying you and putting himself in another's shoes. Thank you for everything.
F
6 years ago
5/5
I have peritoneal carcinomatosis. When I sent my diagnosis to every center, practically all of them agreed on palliative chemo with little survival time, since I had a very aggressive type of cell. Until we reached Dr. Quenet, Dr. Torrent and their team. I can only confirm what their CV announces: they are far ahead of the rest. They saved my life, because during the operation the harmful cells that everyone had diagnosed, and that were the reason nobody would operate on me, were not there. This intervention has become the best investment of my life.
M
6 years ago
5/5
The best decision of my life was finding this excellent team of surgeons who saved my husband's life. At a prestigious international clinic in Madrid he was given up for lost with advanced peritoneal carcinomatosis from appendiceal cancer, and thanks to them, the best professionals in this field, he was operated on very successfully. A perfect recovery with no complications, because they were on top of his progress at all times. They have a great quality: from the start they were very honest and close. I can only be deeply grateful; we went to buy time and thanks to them my husband got his life back.
E
7 years ago
5/5
Dr. Torrent is a brilliant surgeon and a very approachable and warm doctor, whose manner reveals all the qualities that make him a great person and professional: perseverance, innate curiosity and a desire to learn, humility, sincerity and empathy. Going through an operation is undoubtedly an intense experience, physically and emotionally, in which anxieties arise and you feel very vulnerable. All of that is normal, and as his former patient I can say that his care and professionalism throughout the process were absolutely exceptional. I felt very supported by him, with the confidence of knowing I was in the best hands. I will always be grateful to him. Moltes gràcies Dr. Torrent!
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