Percutaneous Laser Ablation of Liver Metastases from Neuroendocrine Neoplasm. A Retrospective Study for Safety and Effectiveness
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To retrospectively assess safety and efficacy of laser ablation (LA) of multiple liver metastases (LM) from neuroendocrine neoplasms (NEN).
Twenty-one patients with NEN and at least 3 LM ≤ 4 cm in diameter underwent ultrasonography-guided LA. Up to seven LM were ablated in a single session; if the number of LM exceeded seven, the remaining LM were ablated in further LA sessions with a time interval of 3–4 weeks. LA was performed according to the multifiber technique. The patients underwent contrast-enhanced CT 1 month after LA, and were subsequently monitored every 3 months for the first 2 years and then every 6 months.
In total, 189 LM were treated in 21 patients (mean 9 ± 8.2, median 6) in 41 LA sessions (range 1–5). The diameter of LM ranged from 5 to 35 mm (median 19 mm, mean 17.9 ± 6.4 mm). One grade 4 complication occurred (0.53%): a bowel perforation managed by surgery. Technical efficacy was 100%, primary efficacy rate 94.7%, and secondary efficacy rate 100%. Complete relief of hormone-related symptoms was obtained in all the 13 symptomatic patients. Median follow-up was 39 months (range 12–99). 1-, 2-, 3-, and 5-year survival rates were 95%, 86%, 66%, and 40%, respectively. Overall survival resulted higher for patients with Ki-67 expression ≤ 7% than for those with Ki-67 > 7% (p = 0.0347).
LA is a promising and safe technique to treat LM from NEN. A longer follow-up should provide definitive information on the long-term efficacy of this liver-directed therapy.
Level of Evidence
Retrospective study, local non-random sample, level 3.
KeywordsNeuroendocrine tumors Liver neoplasms Ablation techniques Laser therapy
This study was not supported by any funding.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
This study has obtained institutional review board approval from the IRB of St. Anna Hospital, and the need for informed consent was waived.
- 8.Öberg K, Knigge U, Kwekkeboom D, Perren A, ESMO Guidelines Working Group. Neuroendocrine gastro-entero-pancreatic tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012;23(Suppl 7):124–30.Google Scholar
- 15.Di Vece F, Tombesi P, Ermili F, Maraldi C, Sartori S. Coagulation areas produced by cool-tip radiofrequency ablation and microwave ablation using a device to decrease back-heating effects: a prospective pilot study. Cardiovasc Intervent Radiol. 2014;37:723–9.Google Scholar
- 28.Wang W, Seeruttun SR, Fang C, Zhou Z. Comprehensive treatment of a functional pancreatic neuroendocrine tumor with multifocal liver metastases. Chin J Cancer Res. 2014;26(4):501–6.Google Scholar
- 29.Perälä J, Klemola R, Kallio R, et al. MRI-guided laser ablation of neuroendocrine tumor hepatic metastases. Acta Radiol Short Rep. 2014;3(1):2047981613499753.Google Scholar
- 34.Ramage JK, Davies AH, Ardill J, UKNET Work for Neuroendocrine Tumours, et al. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut. 2005;54(suppl 4):iv1–16.Google Scholar
- 42.Vogl TJ, Dommermuth A, Heinle B, et al. Colorectal cancer liver metastases: long-term survival and progression-free survival after thermal ablation using magnetic resonance-guided laser-induced interstitial thermotherapy in 594 patients: analysis of prognostic factors. Invest Radiol. 2014;49:48–56.CrossRefGoogle Scholar