Interventional Oncology Approach to Hepatic Metastases

O’Leary, Cathal; Soulen, Michael C.; Shamimi-Noori, Susan

doi:10.1055/s-0040-1719189

Cited by 5 publications

(6 citation statements)

References 80 publications

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“…In a prospective randomised clinical trial, percutaneous cryoablation produced the same 5-year overall survival rate as RFA in the treatment of HCC [ 2 ]. Due to the ease of intraprocedural monitoring of ice ball formation, CRYO is preferable in the vicinity of critical structures such as the diaphragm, heart, lungs, gallbladder and hepatic hilus, preferably for lesions smaller than 4 cm in diameter [ 2 , 5 , 7 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Comparative Study on the Local Tumour Control of Different Ablation Technologies in Primary and Secondary Liver Malignancies

Kovács¹,

Bischoff²,

Haddad³

et al. 2022

JPM

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Purpose: To evaluate local tumour control (LTC) by local ablation techniques (LAT) in liver malignancies. Materials and methods: In patients treated with LAT between January 2013 and October 2020 target lesions were characterised by histology, dimensions in three spatial axes, volume, vascularisation and challenging (CL) location. LAT used were: Radiofrequency Ablation (RFA), Microwave Ablation (MWA), Cryoablation (CRYO), Electrochemotherapy (ECT), and Interstitial Brachytherapy (IBT). Results: 211 LAT were performed in 155 patients. Mean follow-up including MRI for all patients was 11 months. Lesions treated with ECT and IBT were significantly larger and significantly more often located in CL in comparison to RFA, MWA and CRYO. Best LTC (all data for 12 months are given below) resulted after RFA (93%), followed by ECT (81%), CRYO (70%), IBT (68%) and MWA (61%), and further, entity-related for HCC (93%), followed by CRC (83%) and BrC (72%), without statistically significant differences. LTC in hypovascular lesions was worse (64%), followed by intermediate (82% p = 0.01) and hypervascular lesions (92% p = 0.07). Neither diameter (<3 cm: 81%/3–6 cm: 74%/>6 cm: 70%), nor volume (<10 cm3: 80%/10–20 cm3: 86%/>20 cm3: 67%), nor CL (75% in CL vs. 80% in non CL) had a significant impact on LTC. In CL, best LTC resulted after ECT (76%) and IBT (76%). Conclusion: With suitable LAT, similarly good local tumour control can be achieved regardless of lesion size and location of the target.

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Section: Discussionmentioning

confidence: 99%

Long-Term Comparative Study on the Local Tumour Control of Different Ablation Technologies in Primary and Secondary Liver Malignancies

Kovács¹,

Bischoff²,

Haddad³

et al. 2022

JPM

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“…Minimally invasive interventional oncological procedures have increasingly become common alongside the standard therapeutic procedures of surgery, oncology and radiotherapy [13][14][15]. In patients in a general state of health suitable for therapy, they represent a complementary, although in some cases also competitive, therapeutic approach and, particularly in multimorbid patients, are often one of the last options before the decision is made to provide best supportive care [13,16,17]. In practical patient care, however, in addition to the evidence-based therapy recommendation, the availability of the intended procedure is often a decisive criterion for optimal therapy tailored to the patient.…”

Section: Discussionmentioning

confidence: 99%

“…Um einen Eindruck über die Abweichungen zwischen tatsächlich in Deutschland durchgeführten interventionell-onkologischen Tumortherapien und den im DEGIR-Register freiwillig erfassten Interventionen zu erhalten, wurde die im DeGIR-Register erfasste Anzahl der im Jahr 2019 durchgeführten Ablationen mit der im deutschen Krankenhausverzeichnis anhand des entsprechenden Operationen-und Prozedurenschlüssels (OPS) für Ablationen (Leber, Niere, Lunge sowie Knochen) erfassten Anzahl verglichen [12]. Minimal-invasive Verfahren der interventionellen Onkologie haben sich zunehmend neben den "klassischen" Therapieverfahren der Chirurgie, Onkologie sowie Strahlentherapie etabliert [13][14][15]. Sie stellen bei Patienten im therapiefähigen Allgemeinzustand einen komplementären, teilweise allerdings auch kompetitiven Therapieansatz dar und sind insbesondere bei multimorbiden Patienten häufig eine der letzten Optionen vor der Entscheidung zur "Best Supportive Care" [13,16,17].…”

Section: Analyse Zur Flächendeckungunclassified

“…Minimal-invasive Verfahren der interventionellen Onkologie haben sich zunehmend neben den „klassischen“ Therapieverfahren der Chirurgie, Onkologie sowie Strahlentherapie etabliert 13 14 15 . Sie stellen bei Patienten im therapiefähigen Allgemeinzustand einen komplementären, teilweise allerdings auch kompetitiven Therapieansatz dar und sind insbesondere bei multimorbiden Patienten häufig eine der letzten Optionen vor der Entscheidung zur „Best Supportive Care“ 13 16 17 .…”

Section: Diskussionunclassified

“…Neben der hohen Effektivität sowie Etablierung der interventionell-onkologischen Verfahren spielt in der praktischen Patientenversorgung allerdings auch die Verfügbarkeit des Verfahrens sowie die Qualität der Durchführung eine entscheidende Rolle. Minimal-invasive Verfahren der interventionellen Onkologie haben sich zunehmend neben den "klassischen" Therapieverfahren der Chirurgie, Onkologie sowie Strahlentherapie etabliert [13][14][15]. Sie stellen bei Patienten im therapiefähigen Allgemeinzustand einen komplementären, teilweise allerdings auch kompetitiven Therapieansatz dar und sind insbesondere bei multimorbiden Patienten häufig eine der letzten Optionen vor der Entscheidung zur "Best Supportive Care" [13,16,17].…”

Section: Introductionunclassified

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Availability of Interventional Oncology in Germany in the Years 2018 and 2019 – Results from a Nationwide Database (DeGIR Registry Data)

Radosa

Nadjiri

Mahnken

et al. 2022

Rofo

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Objective Over the past few decades, radiology has established itself in tumor therapy through interventional oncology including innovative and efficient procedures for minimalinvasive treatment of various tumor entities besides the “classic” therapeutic options such as surgery, chemotherapy and radiotherapy.Aim of this study was to evaluate the extent to which interventional oncology can provide nationwide care using the data from the register of the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR registry), which records radiological interventions as part of quality assurance. Methods The numbers of interventions of participating clinics, which were recorded as part of module D (oncological procedures including TACE or other tumor-specific embolization, ablation, percutaneous tumor therapy) and identified by the DeGIR registry between 2018 and 2019, were analyzed retrospectively. The collected intervention data were evaluated regarding federal states and 40 smaller regions (administrative districts and former administrative districts). Results In 2018, 11 653 oncological interventions in 187 clinics were recorded by the DeGIR registry. In 2019, the number of participating clinics rose to 216 and the number of oncological interventions increased by 6 % to 12 323. The average number of oncological interventions per clinic decreased slightly from 62.5 (2018) to 57.1 (2019). The DeGIR requirement for being certified as a training center was met by 116 clinics in 2018 including 31 clinics with more than 100 interventions and 129 clinics in 2019 including 36 with more than 100 interventions. Oncological interventions have been performed in each of the 40 regions. An average of 599 interventions per region (standard deviation of 414) was recorded in the period between 2018 and 2019. Conclusion Based on the distribution of the documented oncological interventions at federal state level as well as the district level, the supply of interventional tumor therapy depends on the geographical location. Therefore, the demand of oncological interventions might not be sufficiently covered in some regions. Key Points: Citation Format

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Synergizing liver systemic treatments with interventional oncology: friend or foe?

Jost

Al-Shatti

Ghosn

et al. 2022

The British Journal of Radiology

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Interventional radiology techniques provide excellent local tumor control for small tumors in various organs, but several limitations can hamper the oncological outcomes such as the tumor size or the number of lesions. Technical improvements, optimal patient selection and combination with systemic therapies, including immune checkpoint inhibitors, have been successfully developed to overcome these barriers. In this setting, chemotherapy and targeted therapies aim to diminish the tumor burden in addition to local treatments, while immunotherapies may have a synergistic effect in terms of mechanism of action on the tumor cell as well as the immune environment, with multiple treatment combinations being available. Finally, Interventional Radiology treatments often increase tumor antigen exposure to the immune system and thus stimulate a specific antitumor immune response that can act beyond the treated site. Notwithstanding their many benefits, combination treatment may also result in complications, the most feared may be auto-immune related adverse events. In early studies, several combined therapies have shown promising levels of safety and efficacy, particularly in hepatocellular carcinoma. This review provides a comprehensive and up-to-date overview of results of combined therapies for primary and secondary liver malignancies. Recent advances and future perspectives will be discussed.

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Interventional Oncology Approach to Hepatic Metastases

Cited by 5 publications

References 80 publications

Long-Term Comparative Study on the Local Tumour Control of Different Ablation Technologies in Primary and Secondary Liver Malignancies

Long-Term Comparative Study on the Local Tumour Control of Different Ablation Technologies in Primary and Secondary Liver Malignancies

Availability of Interventional Oncology in Germany in the Years 2018 and 2019 – Results from a Nationwide Database (DeGIR Registry Data)

Synergizing liver systemic treatments with interventional oncology: friend or foe?

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