New option looks promising for those with liver mets only

1: Surg Endosc. 2005 Oct 24; [Epub ahead of print] Related Articles, Links

Laparoscopic radiofrequency thermal ablation for unusual hepatic tumors: operative indications and outcomes.

Berber E, Ari E, Herceg N, Siperstein A.

Department of General Surgery/A 80, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA, sipersa@ccf.org.

BACKGROUND: There is increasing experience with laparoscopic radiofrequency ablation for the treatment of patients with hepatic metastasis from colorectal and neuroendocrine cancer and those with hepatocellular cancer. Little is known about the outcomes for patients with other tumor types. METHODS: Between January 1996 and March 2005, 517 patients with 1,500 primary and metastatic liver tumors underwent laparoscopic radiofrequency ablation. Among these, 53 patients (10%) had cancers other than the colorectal, neuroendocrine, or hepatocellular types including sarcoma (n = 18), breast cancer (n = 10), esophagus cancer (n = 4), melanoma (n = 4), lung cancer (n = 3), ovarian cancer (n = 2), pancreas cancer (n = 2), unknown primary cancer (n = 2), cholangiocarcinoma (n = 2), rectal squamous cancer (n = 2), renal cancer (n = 2), papillary thyroid cancer (n = 1), and hemangioendothelioma (n = 1). Unlike the criteria for treatment of the more usual tumor types, these patients had a diagnosis of liver-exclusive disease, as diagnosed by preoperative imaging. They also had failed chemotherapy. RESULTS: The 53 patients underwent ablation of 192 lesions, with 8 patients undergoing repeat treatment. The hospital stay averaged 1 day, and there was no 30-day mortality. Complications included one postoperative hemorrhage, one liver abscess, and one wound infection. Tumors recurred locally for 17% of the lesions over a mean follow-up period of 24 months. The overall median survival was 33 months for the whole series, more than 51 months for breast cancer, and 25 months for sarcoma. CONCLUSION: Laparoscopic radiofrequency ablation can safely and effectively treat hepatic metastasis of these unusual tumor types. The authors believe that this heterogeneous group of patients, selected for their unusual presentation of liver-exclusive disease, may benefit from cytoreduction of their tumor by laparoscopic radiofrequency ablation when other treatment methods have failed.

PMID: 16247574 [PubMed - as supplied by publisher]

[Cindi]

Lani,

Thank you for the information. I am curious though by your statement of "swearing to never post again"...if you care to answer, why is that?

Maybe you just prefer to "lurk", but I was just curious.

God Bless,
Cindi.

If you look up a history of my previous posts (and in one case its timing) and replies it should become evident.

[lu ann]

Lani, you are not registered, so we can't view your history. Did you have a problem with one of the members? There have been times when I have felt left out of the groove, but I get over things quick and realize that everyone is human and is entitiled to make a mistake or two. You seem to have alot to offer and I hope you will continue to post your opinions. Blessings, Lu Ann.

[StephN]

Hi Lani -
I found this to be an interesting article. As a survivor of major liver mets, I am always on the lookout for new info on treating this area. My liver is clean now and has been for 3.5 years, but that could change any time. I am a realist about my cancer, but try to stay on the positive side.

In my case ablation was not an option to "get" one stubborn remaining tumor. It was wrapped around a main hepatic vein and well nourished. That meant I had to stay an chemo (taxol & navelbine) a little longer to shut it down completely. But ablation was looked at as an option to get me off chemo a little sooner.

RFA has been used by a couple of the members of this board with some good success for both lung and liver spots.

[jessica]

Steph~
Like you, I have battled a single, pesky spot in my liver, sitting in between the main portal vein and the inferior vena cava. I did have RFA & unfortunately it wasn't completely successful (because of the location), so I did have to do another 6mos of chemo to get to NED again (thank God).
My docs feel certain that the spot is going to come back again, and wanted to consider resection, but that would involve cutting out a portion of the IVC and then reconstructing it. That's waay too much surgery for my taste.
After reading that you've been NED for 3.5 years, I feel hopeful that I'm not going to have to go thru this, on & off chemo, short hair/no hair, year after year after year!
Thanks for posting-you always contribute such great info & perspective!
Keep the Faith!

[StephN]

Hey there, Jessica -
Yes, I recall your posts about that single liver met. So GLAD the chemos did the trick finally. My med onc said that if the chemo did not get that tumor they would try a resection, but that was considered a last resort. I would leave yours alone on the basis of my med oncs advice.

About the statement that your docs feel this tumor will rear its ugly head again. My scans show that the stubborn tumor is GONE - not even scarring there at this point. My whole liver cleaned itself up and my med onc says no one would believe how it looked in Jan of 2004! Swiss cheese with shotgun holes added in!

So, if you still have a small spot where the tumor was, that does not mean that it will come back. What would probably happen to me is a whole new crop of tumors. But they have to get past the Herceptin and my own stronger immune system now. So, I just plan to be another Ginger Empy and carry on with my life!

Good to hear from you!