Liver Resection After Selective Internal Radiation Therapy with Yttrium-90: Safety and Outcomes

Mafeld, Sebastian; Littler, Peter; Hayhurst, Hannah; Manas, Derek; Jackson, Ralph; Moir, John; French, Jeremy

doi:10.1007/s12029-019-00221-0

Cited by 8 publications

(5 citation statements)

References 38 publications

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“…The available data derived from a small number of patients with HCC ( n = 5), lmCRC ( n = 5) and neuroendocrine tumors ( n = 2), reported mean time from intervention with Y-90 TARE to resection of 322 days (range 195–703) [ 42 ]. According to an analysis by Berry et al [ 43 ], waiting at least 8 weeks after an intervention with Y-90 TARE until surgery is recommended; however, the optimal time will depend on achieving the maximum benefit that TARE can present, which is between 3 and 6 months.…”

Section: Resultsmentioning

confidence: 99%

Recommendations for the management of yttrium-90 radioembolization in the treatment of patients with colorectal cancer liver metastases: a multidisciplinary review

González-Flores,

Zambudio,

Pardo-Moreno

et al. 2023

Clin Transl Oncol

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Purpose Strategies for the treatment of liver metastases from colon cancer (lmCRC) are constantly evolving. Radioembolization with yttrium 90 (Y-90 TARE) has made significant advancements in treating liver tumors and is now considered a potential option allowing for future resection. This study reviewed the scientific evidence and developed recommendations for using Y-90 TARE as a treatment strategy for patients with unresectable lmCRC. Methods A multidisciplinary scientific committee, consisting of experts in medical oncology, hepatobiliary surgery, radiology, and nuclear medicine, all with extensive experience in treating patients with ImCRC with Y-90 TARE, led this project. The committee established the criteria for conducting a comprehensive literature review on Y-90 TARE in the treatment of lmCRC. The data extraction process involved addressing initial preliminary inquiries, which were consolidated into a final set of questions. Results This review offers recommendations for treating patients with lmCRC using Y-90 TARE, addressing four areas covering ten common questions: 1) General issues (multidisciplinary tumor committee, indications for treatment, contraindications); 2) Previous process (predictive biomarkers for patient selection, preintervention tests, published evidence); 3) Procedure (standard procedure); and 4) Post-intervention follow-up (potential toxicity and its management, parameters for evaluation, quality of life). Conclusions Based on the insights of the multidisciplinary committee, this document offers a comprehensive overview of the technical aspects involved in the management of Y-90 TARE. It synthesizes recommendations for applying Y-90 TARE across various phases of the treatment process.

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Section: Resultsmentioning

confidence: 99%

Recommendations for the management of yttrium-90 radioembolization in the treatment of patients with colorectal cancer liver metastases: a multidisciplinary review

González-Flores,

Zambudio,

Pardo-Moreno

et al. 2023

Clin Transl Oncol

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“…However, recurrence is likely, and calculation of post-surgery steps should be taken into consideration, including either surveillance or continuation of systemic treatment. This is also true for locoregional strategies, e.g., SIRT, where limited data is available that this is feasible in highly selected cases [99].…”

Section: Pnet With Extensive Liver Metastasis (>50%) or Extrahepatic ...mentioning

confidence: 99%

Orchestrating Treatment Modalities in Metastatic Pancreatic Neuroendocrine Tumors—Need for a Conductor

Siebenhüner

Langheinrich

Friemel

et al. 2022

Cancers

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Pancreatic neuroendocrine tumors (pNETs) are a vast growing disease. Over 50% of these tumors are recognized at advanced stages with lymph node, liver, or distant metastasis. An ongoing controversy is the role of surgery in the metastatic setting as dedicated systemic treatments have emerged recently and shown benefits in randomized trials. Today, liver surgery is an option for advanced pNETs if the tumor has a favorable prognosis, reflected by a low to moderate proliferation index (G1 and G2). Surgery in this well-selected population may prolong progression-free and overall survival. Optimal selection of a treatment plan for an individual patient should be considered in a multidisciplinary tumor board. However, while current guidelines offer a variety of modalities, there is so far only a limited focus on the right timing. Available data is based on small case series or retrospective analyses. The focus of this review is to highlight the right time-point for surgery in the setting of the multimodal treatment of an advanced pancreatic neuroendocrine tumor.

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“…Importantly, in selected cases, liver resection may be possible post RE, as depicted in a recent study of NELM and other malignancies [ 104 ]. Therefore, it may be prudent to reconsider hepatectomy in patients undergoing transarterial embolization modalities.…”

Section: Non-surgical Liver-targeted Treatmentsmentioning

confidence: 99%

Currently available treatment options for neuroendocrine liver metastases

Machairas

Daskalakis²,

Felekouras

et al. 2021

aog

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Neuroendocrine neoplasms (NEN) are frequently characterized by a high propensity for metastasis to the liver, which appears to be a dominant site of distant-stage disease, affecting quality of life and overall survival. Liver surgery with the intention to cure is the treatment of choice for resectable neuroendocrine liver metastases (NELM), aiming to potentially prolong survival and ameliorate hormonal symptoms refractory to medical control. Surgical resection is indicated for patients with NELM from well-differentiated NEN, while its feasibility and complexity are largely dictated by the degree of liver involvement. As a result of advances in surgical techniques over the past decades, complex 1- and 2-stage, or repeat liver resections are performed safely and effectively by experienced surgeons. Furthermore, liver transplantation for the treatment of NELM should be anchored in a multimodal and multidisciplinary therapeutic strategy and restricted only to highly selected individual cases. A broad spectrum of interventional radiology treatments for NELM have recently been available, with expanding indications that are more applicable, as they are less limited by patient- and tumor-related parameters, being therefore important adjuncts or alternatives to surgery. Overall, liver-targeted treatment modalities may precede the administration of systemic molecular targeted agents and chemotherapy for patients with liver-dominant metastatic disease; these appear to be a crucial component of multimodal management of patients with NEN. In the present review, we discuss surgical and non-surgical liver-targeted treatment approaches for NELM, each complementing the other, with a view to assisting physicians in optimizing multimodal NEN patient care.

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Liver Resection After Selective Internal Radiation Therapy with Yttrium-90: Safety and Outcomes

Cited by 8 publications

References 38 publications

Recommendations for the management of yttrium-90 radioembolization in the treatment of patients with colorectal cancer liver metastases: a multidisciplinary review

Recommendations for the management of yttrium-90 radioembolization in the treatment of patients with colorectal cancer liver metastases: a multidisciplinary review

Orchestrating Treatment Modalities in Metastatic Pancreatic Neuroendocrine Tumors—Need for a Conductor

Currently available treatment options for neuroendocrine liver metastases

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