Radiofrequency Ablation for Neuroendocrine Liver Metastases: A Systematic Review

Mohan, Helen; Nicholson, Patrick; Winter, D. C.; O’Shea, Donal; O’Toole, Dermot; Geoghegan, Justin; Maguire, D; Hoti, Emir; Traynor, O.; Cantwell, Colin P.

doi:10.1016/j.jvir.2014.12.009

Cited by 83 publications

(45 citation statements)

References 43 publications

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“…Radiofrequency ablation (RFA) is a medical procedure by which the liver metastatic tissue is ablated using the heat generated from medium-frequency alternating current (in the range of 350-500 kHz). Thermal ablation can be reached through microwave, a non-ionizing form of radiation that generates very high temperatures in very short timeperiods, potentially leading to improved treatment efficiency and larger ablation zones: thus, microwave ablation is emerging as a valuable alternative to radiofrequency ablation in the treatment of hepatic malignancies[43]. Radiofrequency ablation (RFA) and microwave ablation are the most favored techniques to address neuroendocrine liver metastases and 5-year OS rates of up to 53% have been reported[44].…”

Section: Locoregional Treatmentsmentioning

confidence: 99%

Is there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?

Cavalcoli

Rausa

Conte

et al. 2017

WJG

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Gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) frequently present with distant metastases at the time of diagnosis and the liver is the most frequent site of spreading. The early identification of metastatic disease represents a major prognostic factor for GEP-NENs patients. Radical surgical resection, which is feasible for a minority of patients, is considered the only curative option, while the best management for patients with unresectable liver metastases is still being debated. In the last few years, a number of locoregional and systemic treatments has become available for GEP-NEN patients metastatic to the liver. However, to date only a few prospective studies have compared those therapies and the optimal management option is based on clinical judgement. Additionally, locoregional treatments appear feasible and safe for disease control for patients with limited liver involvement and effective in symptoms control for patients with diffuse liver metastases. Considering the lack of randomized controlled trials comparing the locoregional treatments of liver metastatic NEN patients, clinical judgment remains key to set the most appropriate therapeutic pathway. Prospective data may ultimately lead to more personalized and optimized treatments. The present review analyzes all the locoregional therapy modalities (i.e., surgery, ablative treatments and transarterial approach) and aims to provide clinicians with a useful algorithm to best treat GEP-NEN patients metastatic to the liver.

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Section: Locoregional Treatmentsmentioning

confidence: 99%

Is there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?

Cavalcoli

Rausa

Conte

et al. 2017

WJG

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“…These are almost exclusively related to medullary thyroid cancer except for a case of rapidly progressive FTC metastasis, with RFA used mainly for cytoreduction and palliation [23, 24]. In addition, to our knowledge, there are no available published data regarding treatment of any distal thyroid cancer metastases with MWA.…”

Section: Discussionmentioning

confidence: 99%

Isolated Liver Metastasis in Hürthle Cell Thyroid Cancer Treated with Microwave Ablation

Segkos

Schmidt

Nabhan

2017

Case Reports in Endocrinology

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Hürthle cell thyroid cancer (HCTC) is a less common form of differentiated thyroid cancer. It rarely metastasizes to the liver, and when it does, the metastasis is almost never isolated. Here we report a 62-year-old male with widely invasive Hürthle cell thyroid cancer, who underwent total thyroidectomy and received adjuvant treatment with I-131 with posttreatment scan showing no evidence of metastatic disease. His thyroglobulin however continued to rise after that and eventually an isolated liver metastasis was identified. He underwent laparoscopic microwave ablation of the liver metastasis, with dramatic decline in thyroglobulin and no structural disease identified to date. This case highlights the rare occurrence of isolated liver metastasis from HCTC and also illustrates the utility of thermoablation as an alternative to surgical resection in the treatment of small isolated liver metastases from HCTC.

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“…H. Mohan и соавт. [23], изучив применение РЧА у пациентов с генерализованными НЭО, установили развитие симптоматического эффекта в виде регресса гиперсекреторных симптомов у 95% больных. В то же время авторами [20] установлено прогрессирование заболевания в течение 5 лет у 63-87% больных.…”

Section: оригинальные статьиunclassified

“…Эффективность методов абляции зависит от количества, размера, локализации метастазов в печени, а также от опыта их практического применения. Несмотря на эффективность локальных методов деструкции печеночных метастазов НЭО, они являются дополнительными в программе лечения больных, позволяющими уменьшить выраженность гиперсекреторных синдромов, в меньшей степени замедлить опухолевую прогрессию [21,23].…”

Section: оригинальные статьиunclassified

Possibilities of treating patients with generalized neuroendocrine tumors

Лысанюк¹,

Майстренко²,

Romashchenko³

et al. 2018

Onkol. Z. im. P.A. Gercena

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Цель исследования-уточнить рациональную тактику лечения больных с генерализованными нейроэндокринными опухолями (НЭО) желудочно-кишечного тракта и поджелудочной железы, позволяющую увеличить продолжительность и качество жизни пациентов. Материал и методы. Изучены результаты обследования и лечения 63 больных с генерализованными НЭО желудочно-кишечного тракта и поджелудочной железы. Комплексное лечение проведено 32 (50,8%) больным, лекарственная терапия в качестве единственного метода лечения-31 (49,2%) пациенту. Результаты. Установлено, что комплексное лечение по сравнению с лекарственной терапией обеспечило увеличение выживаемости больных с НЭО G1-G2 в 2 раза (с 29,9 до 60 мес) и нейроэндокринной карциномой (НЭК) G3 в 2,9 раза (с 10,1 до 28,5 мес). Определены неблагоприятные прогностические факторы течения заболевания, которыми являются: 1) локализация первичной опухоли в поджелудочной железе; 2) метастатическое поражение печени III типа; 3) наличие НЭК G3; 4) проведение лекарственной терапии в качестве единственного вида лечения (р<0,05). Заключение. Лечение больных с генерализованными НЭО необходимо проводить в специализированных медицинских центрах, имеющих возможность реализации мультидисциплинарного подхода, позволяющего достоверно увеличить продолжительность и качество жизни пациентов. Ключевые слова: нейроэндокринная опухоль, нейроэндокринная карцинома, комплексное лечение.

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Radiofrequency Ablation for Neuroendocrine Liver Metastases: A Systematic Review

Cited by 83 publications

References 43 publications

Is there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?

Is there still a role for the hepatic locoregional treatment of metastatic neuroendocrine tumors in the era of systemic targeted therapies?

Isolated Liver Metastasis in Hürthle Cell Thyroid Cancer Treated with Microwave Ablation

Possibilities of treating patients with generalized neuroendocrine tumors

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