Metastatic disease to the liver: Locoregional therapy strategies and outcomes

Zane, Kylie E; Cloyd, Jordan M.; Mumtaz, Khalid; Wadhwa, Vibhor; Makary, Mina S.

doi:10.5306/wjco.v12.i9.725

Cited by 16 publications

(15 citation statements)

References 147 publications

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“…In MDTB decisions, chemo holidays, shorter hospital stays and the associated shorter downtimes of patients are an increasingly important argument for IO [ 19 , 20 , 21 , 22 ]. Image-guided LAT have developed rapidly in the last decades, with significant technical improvements that have led to both an improved safety profile and better clinical outcomes [ 8 , 23 , 24 , 25 ]. From today’s perspective, the next requirements for LAT are to expand the indications, control the ablation field more precisely and achieve better long-term outcomes [ 5 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, depending on the entity, the actual lesion borders cannot be captured equally well with all imaging modalities [ 8 , 18 , 32 , 33 ]. In colorectal cancer metastases, there is a discrepancy between the demarcation of lesion margins on contrast-enhanced CT and multiparametric MRI [ 11 , 24 , 28 ]. To achieve the best possible detection of tumour margins, we planned our study using both MR and CT imaging.…”

Section: Discussionmentioning

confidence: 99%

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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%

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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“…In some cases, OMD progresses slowly, affecting the function of major organs (oligo-progression). However, locoregional treatments can be intermittently and reasonably prolonged until advanced stages of the disease in these patients [ 58 , 59 ]. In other patients, a clear and clinically aggressive polymetastatic disease develops (“poly-metastatic progression”), requiring a classical approach based primarily on the administration of multiple lines of non-cross-resistant systemic chemotherapy.…”

Section: Definitive Local Therapies In Omdmentioning

confidence: 99%

Oligo-Metastatic Cancers: Putative Biomarkers, Emerging Challenges and New Perspectives

Ottaiano

Santorsola

Circelli³

et al. 2023

Cancers

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Some cancer patients display a less aggressive form of metastatic disease, characterized by a low tumor burden and involving a smaller number of sites, which is referred to as “oligometastatic disease” (OMD). This review discusses new biomarkers, as well as methodological challenges and perspectives characterizing OMD. Recent studies have revealed that specific microRNA profiles, chromosome patterns, driver gene mutations (ERBB2, PBRM1, SETD2, KRAS, PIK3CA, SMAD4), polymorphisms (TCF7L2), and levels of immune cell infiltration into metastases, depending on the tumor type, are associated with an oligometastatic behavior. This suggests that OMD could be a distinct disease with specific biological and molecular characteristics. Therefore, the heterogeneity of initial tumor burden and inclusion of OMD patients in clinical trials pose a crucial methodological question that requires responses in the near future. Additionally, a solid understanding of the molecular and biological features of OMD will be necessary to support and complete the clinical staging systems, enabling a better distinction of metastatic behavior and tailored treatments.

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“…The development of a metastatic disease in UM is among the factors with the biggest impact in the definition of life expectancy of the UM patient [ 7 , 8 ]. Unless metastases are detected early and submitted to ablation therapy, the presence of metastases in UM is a marker of early death, given that effective therapeutic options for the metastatic UM disease are still limited [ 124 , 125 ]. In fact, recent studies demonstrate a median survival time of 17.5 months for M1a (largest diameter of the largest metastasis less than or equal to 3 cm), 9.6 months for M1b (largest diameter of the largest metastasis 3.1–8.0 cm) and 5 months for M1c (largest diameter of the largest metastasis greater than or equal to 8.1 cm) once metastatic UM disease is detected [ 98 ].…”

Section: Current Well-established Prognostic Biomarkers In Uveal Melanomamentioning

confidence: 99%

Prognostic Biomarkers in Uveal Melanoma: The Status Quo, Recent Advances and Future Directions

Lamas

Martel

Nahon-Estève

et al. 2021

Cancers

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Uveal melanoma (UM) is the most common malignant intraocular tumour in the adult population. It is a rare cancer with an incidence of nearly five cases per million inhabitants per year, which develops from the uncontrolled proliferation of melanocytes in the choroid (≈90%), ciliary body (≈6%) or iris (≈4%). Patients initially present either with symptoms like blurred vision or photopsia, or without symptoms, with the tumour being detected in routine eye exams. Over the course of the disease, metastases, which are initially dormant, develop in nearly 50% of patients, preferentially in the liver. Despite decades of intensive research, the only approach proven to mildly control disease spread are early treatments directed to ablate liver metastases, such as surgical excision or chemoembolization. However, most patients have a limited life expectancy once metastases are detected, since there are limited therapeutic approaches for the metastatic disease, including immunotherapy, which unlike in cutaneous melanoma, has been mostly ineffective for UM patients. Therefore, in order to offer the best care possible to these patients, there is an urgent need to find robust models that can accurately predict the prognosis of UM, as well as therapeutic strategies that effectively block and/or limit the spread of the metastatic disease. Here, we initially summarized the current knowledge about UM by compiling the most relevant epidemiological, clinical, pathological and molecular data. Then, we revisited the most important prognostic factors currently used for the evaluation and follow-up of primary UM cases. Afterwards, we addressed emerging prognostic biomarkers in UM, by comprehensively reviewing gene signatures, immunohistochemistry-based markers and proteomic markers resulting from research studies conducted over the past three years. Finally, we discussed the current hurdles in the field and anticipated the future challenges and novel avenues of research in UM.

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Metastatic disease to the liver: Locoregional therapy strategies and outcomes

Cited by 16 publications

References 147 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

Oligo-Metastatic Cancers: Putative Biomarkers, Emerging Challenges and New Perspectives

Prognostic Biomarkers in Uveal Melanoma: The Status Quo, Recent Advances and Future Directions

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