Adjunctive radiofrequency ablation of metastatic neuroendocrine cancer to the liver complements surgical resection
- PMID: 23374359
- PMCID: PMC3572279
- DOI: 10.1111/j.1477-2574.2012.00528.x
Adjunctive radiofrequency ablation of metastatic neuroendocrine cancer to the liver complements surgical resection
Abstract
Background: Resection of liver metastases from neuroendocrine cancer (NEC) prolongs survival and provides durable symptom relief. Not all hepatic lesions are amenable to resection, particularly when there is multifocal involvement. In this study, it was hypothesized that ablation of concomitant non-resectable NEC liver metastases is safe and salvages patients who would not have been selected for cytoreductive surgery.
Methods: Patients who underwent adjuvant ablation of NEC liver metastases between 1995 and 2008 were reviewed. NEC was classified by patient and tumour characteristics. Regression and Kaplan-Meier models were used to compare variables and generate survival curves.
Results: Ninety-four patients underwent hepatic resection and intra-operative ablation of metastatic NEC. The median number of lesions ablated was 3, and median size was 1.4 cm. One abscess occurred at an ablation site. Local recurrence was detected in four patients (3.8%). Overall survival was 80% and 59% at 5 and 10 years. Age, gender, tumour type, grade, primary site and need for repeat ablation had no significant association with survival. The Ki67 proliferative index was a significant predictor of decreased survival. Symptom-free survival was 34% at 3 years and 16% at 5 years, independent of the tumour grade.
Conclusion: Concurrent ablation of NEC metastases to the liver not amenable to resection is safe and increases the candidacy of patients for cytoreductive surgery. Ablation performed intra-operatively and repeated post-operatively as needed provides significant symptom control regardless of the tumour grade.
© 2012 International Hepato-Pancreato-Biliary Association.
Figures
Similar articles
-
Hepatic surgery for metastases from neuroendocrine tumors.Surg Oncol Clin N Am. 2003 Jan;12(1):231-42. doi: 10.1016/s1055-3207(02)00076-5. Surg Oncol Clin N Am. 2003. PMID: 12735141 Review.
-
Laparoscopic radiofrequency ablation of neuroendocrine liver metastases: a 10-year experience evaluating predictors of survival.Surgery. 2007 Jul;142(1):10-9. doi: 10.1016/j.surg.2007.01.036. Surgery. 2007. PMID: 17629995
-
Radiofrequency ablation for neuroendocrine liver metastases: a systematic review.J Vasc Interv Radiol. 2015 Jul;26(7):935-942.e1. doi: 10.1016/j.jvir.2014.12.009. Epub 2015 Mar 31. J Vasc Interv Radiol. 2015. PMID: 25840836 Review.
-
Long-term survival after surgical management of neuroendocrine hepatic metastases.HPB (Oxford). 2010 Aug;12(6):427-33. doi: 10.1111/j.1477-2574.2010.00198.x. HPB (Oxford). 2010. PMID: 20662794 Free PMC article.
-
Results after surgical treatment of liver metastases in patients with high-grade gastroenteropancreatic neuroendocrine carcinomas.Eur J Surg Oncol. 2017 Sep;43(9):1682-1689. doi: 10.1016/j.ejso.2017.04.010. Epub 2017 May 4. Eur J Surg Oncol. 2017. PMID: 28522174
Cited by
-
Liver-Directed Locoregional Therapies for Neuroendocrine Liver Metastases: Recent Advances and Management.Curr Oncol. 2024 Apr 5;31(4):2076-2091. doi: 10.3390/curroncol31040154. Curr Oncol. 2024. PMID: 38668057 Free PMC article. Review.
-
Technical and Clinical Outcomes of Laparoscopic-Laparotomic Hepatocellular Carcinoma Thermal Ablation with Microwave Technology: Case Series and Review of Literature.Cancers (Basel). 2023 Dec 24;16(1):92. doi: 10.3390/cancers16010092. Cancers (Basel). 2023. PMID: 38201536 Free PMC article.
-
Neuroendocrine Tumors: Genomics and Molecular Biomarkers with a Focus on Metastatic Disease.Cancers (Basel). 2023 Apr 12;15(8):2249. doi: 10.3390/cancers15082249. Cancers (Basel). 2023. PMID: 37190177 Free PMC article. Review.
-
Defining a New Classification System for the Surgical Management of Neuroendocrine Tumor Liver Metastases.J Clin Med. 2023 Mar 23;12(7):2456. doi: 10.3390/jcm12072456. J Clin Med. 2023. PMID: 37048539 Free PMC article. Review.
-
Reliability of Stereotactic Radiofrequency Ablation (SRFA) for Malignant Liver Tumors: Novice versus Experienced Operators.Biology (Basel). 2023 Jan 22;12(2):175. doi: 10.3390/biology12020175. Biology (Basel). 2023. PMID: 36829454 Free PMC article.
References
-
- Chamberlain RS, Canes D, Brown KT, Saltz L, Jarnagin W, Fong Y. Hepatic neuroendocrine metastases: does intervention alter outcomes? J Am Coll Surg. 2000;190:432–445. et al. - PubMed
-
- Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13 715 carcinoid tumors. Cancer. 2003;97:934–959. - PubMed
-
- Bajetta E, Ferrari L, Procopio G, Catena L, Ferrario E, Martinetti A. Efficacy of a chemotherapy combination for the treatment of metastatic neuroendocrine tumours. Ann Oncol. 2002;13:614–621. et al. - PubMed
-
- Rinke A, Muller HH, Schade-Brittinger C, Klose KJ, Barth P, Wied M. Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of tumor growth in patients with metastatic neuroendocrine midgut tumors: a report from the PROMID Study Group. J Clin Oncol. 2009;27:4656–4663. et al. - PubMed
-
- Mayo SC, de Jong MC, Pulitano C, Clary BM, Reddy SK, Gamblin TC. Surgical management of hepatic neuroendocrine tumor metastasis: results from an international multi-institutional analysis. Ann Surg Oncol. 2010;17:3129–3136. et al. - PubMed
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical