Usefulness of intraoperative radiofrequency thermoablation of liver tumours associated or not with hepatectomy

Elias, D.; Goharin, A.; Otmany, A. El; Taïeb, J.; Duvillard, P.; Lasser, P; Baère, Thierry De

doi:10.1053/ejso.2000.1000

Cited by 105 publications

(54 citation statements)

References 12 publications

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“…Combining hepatic resection with ablation can expand the number of patients who may be candidates for liver-directed surgical therapy, particularly as larger lesions that are less effectively treated with ablation can be resected and small lesions can be ablated [63]. Although tumor ablation should not be viewed as a replacement to resection, it does have applicability in patients who do not meet the criteria for resectability but are candidates for liver-directed therapy based upon the presence of liver-only disease.…”

Section: Combined Local Therapy: Resection Plus Rfamentioning

confidence: 99%

Expanding Criteria for Resectability of Colorectal Liver Metastases

2008

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After completing this course, the reader will be able to:1. Identify the criteria for hepatic resection of colorectal metastases.2. Describe strategies for expanding the number of patients who may potentially benefit from hepatic resection.3. List the factors associated with poor prognosis following hepatic resection.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTSurgical resection is the treatment of choice in patients with colorectal liver metastases, with 5-year survival rates reported in the range of 40%-58%. Over the past 10 years, there has been an impetus to expand the criteria for defining resectability for patients with colorectal metastases. In the past, such features as the number of metastases (three to four), the size of the tumor lesion, and a mandatory 1-cm margin of resection dictated who was "resectable." More recently, the criteria for resectability have been expanded to include any patient in whom all disease can be removed with a negative margin and who has adequate hepatic volume/reserve. Specifically, instead of resectability being defined by what is removed, decisions concerning resectability now center around what will remain after resection. Under this new paradigm, the number of patients with resectable disease can be expanded by increasing/preserving hepatic reserve (e.g., portal vein embolization, two-stage hepatectomy), combining resection with ablation, and decreasing tumor size (preoperative chemotherapy). The criteria for resectability have also expanded to include patients with extrahepatic disease. Rather than being an absolute contraindication to surgery, patients with both intra-and extrahepatic disease should potentially be considered for resection based on strict selection criteria. The expansion of criteria for resectability of colorectal liver metastases requires a much more nuanced and sophisticated approach to the patient with advanced disease. A therapeutic approach that includes all aspects of multidisciplinary and multimodality care is required to select and treat this complex group of patients. The Oncologist 2008;13:51-64

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Section: Combined Local Therapy: Resection Plus Rfamentioning

confidence: 99%

Expanding Criteria for Resectability of Colorectal Liver Metastases

2008

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“…LRFA is indicated for deep-situated (<3 cm) tumors while resection is feasible and safety for exophitic/subcapsular tumors. The association of resection with RFA was found to be a safe procedure with long term outcomes better than the ablation but poorer than resection alone [59].…”

Section: Association Of Lrfa With Other Therapeutic Methodsmentioning

confidence: 95%

Laparoscopic Radiofrequency Ablation of Liver Tumors

Boeti¹,

Grigorie²,

Popescu³

2013

Hepatic Surgery

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Section: Combining Resection With Local Therapiesmentioning

confidence: 99%

“…Ablation of liver tumour was developed originally as an alternative option to surgical resection for unresectable lesions (43). Combining hepatic resection with ablation can expand the number of patients who may be candidates for liver directed surgical therapy, particularly as larger lesions, which are less effectively treated with ablation, can be resected and small lesions can be ablated (22,44).The term "tumour ablation" is defined as a direct local application of chemical(s) or thermal energy to achieve tumour destruction. It can be performed percutaneously, laparoscopically, or at open surgery, and is currently used for tumours up to 5 cm in diameter.…”

mentioning

confidence: 99%

Surgical treatment of colorectal cancer liver metastases

Šimčikas¹,

Paškonis²,

Sokolovas³

et al. 2011

AML

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Background. Colorectal cancer is a major health problem. Approximately 25% of the patients present with liver metastases at initial diagnosis and more than 50% develop metastases in the course of illness. Over the last few decades, with improvements in therapy, the management of colorectal liver metastases has changed dramatically.In this review, we explore various current modalities of care, with surgical treatment ahead, for patients with colorectal liver metastases and present a brief report about the Vilnius University Hospital Santariskiu Clinics experience in the surgical treatment of metastatic liver disease.Methods. The Medline / PubMed literature database was searched for articles on the topics of colorectal liver metastases, including criteria of surgical resectability, chemotherapy, adjunctive and locoregional therapies. Also, results of the surgical treatment of liver metastases at the Vilnius University Hospital Santariskiu Clinics were analysed.Results. Globally, surgical liver resection for colorectal liver metastases remains the only regular curative treatment with the 5-year survival rates reported as 20-50%. With improvements in therapy, resectability criteria are expanding. Hepatic metastases are primarily resectable in 15-25% cases only. Up to 25% of patients with initially non-resectable metastases become amenable to a potentially curative operation after interdisciplinary treatment involving preoperative chemotherapy, portal vein embolization or ligation, few-stage hepatectomy, and / or locally ablative procedures.We observed good and optimistic survival results in the Vilnius University Hospital Santariskiu Clinics patient population after liver resection: 1-, 2-and 3-year survival was 86.9%, 63.5% and 42.3%, respectively.Conclusions. Over the last ten years, liver surgery has changed dramatically. A thorough selection of patients with colorectal liver metastases in a multidisciplinary team may improve treatment results significantly. Surgical treatment results for liver metastases at the Vilnius University Hospital Santariskiu Clinics are good.Key words: colorectal liver metastases, liver resection, ablation, chemotherapy, portal vein embolisation INTRODUCTIONColorectal cancer (CRC) is a major health problem. Nearly one million new cases are diagnosed worldwide annually (1). It is the third most frequent cancer and the second leading cause of cancer-related deaths in the European Union (2) and in the United States (3). Metastases are the most common neo plasms in an adult liver; however, their true prevalence is unknow. Liver is the most common site of CRC metastases which extremely worsen the prognosis. Approximately 25% present with metastases at the initial diagnosis and more than 50% of patients with colorectal cancer will develop metastases in the course of illness (4,5).Over the last few decades, the management of colorectal liver metastases (CLM) has changed dramatically. Without treatment, the median survival of patients with CLM is 5-10 months (5). Improvements in the diagnostics...

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Usefulness of intraoperative radiofrequency thermoablation of liver tumours associated or not with hepatectomy

Cited by 105 publications

References 12 publications

Expanding Criteria for Resectability of Colorectal Liver Metastases

Expanding Criteria for Resectability of Colorectal Liver Metastases

Laparoscopic Radiofrequency Ablation of Liver Tumors

Surgical treatment of colorectal cancer liver metastases

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