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Radiofrequency ablation of neuroendocrine liver metastases—the Middlesex experience

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Abstract

Background

Current treatment options for neuroendocrine liver metastases are not widely applicable or not that effective. Image-guided thermal ablation offers the possibility of a minimally invasive, albeit palliative, treatment that decreases tumor volume, preserves most of the normal liver, and can be repeated several times. We report our experience with image-guided thermal ablation in 25 patients with unresectable liver metastases.

Methods

Since 1990 we have treated 189 tumors at 66 treatment sessions in 25 patients (12 female, 13 male; median age, 56 years; age range, 26–78 years). Thirty treatments were performed with a solid-state laser, and 36 treatments were performed with radiofrequency ablation. All but one treatment was performed percutaneously under image guidance. Sixteen patients had metastases from carcinoid primaries, three from gastrinoma, two from insulinoma, and four from miscellaneous causes. Fourteen of 25 had symptoms from hormone secretion.

Results

Imaging follow-up was available in 19 patients at a median of 21 months (range, 4–75 months). There was a complete response in six patients, a partial response in seven, and stable disease in one; hence, tumor load was controlled in 14 of 19 patients (74%). Relief of hormone-related symptoms was achieved in nine of 14 patients (69%). The median survival period from the diagnosis of liver metastases was 53 months. One patient with end-stage cardiac disease died after a carcinoid crisis. There were eight (12%) complications: five local and three distant, four major and four minor.

Conclusions

As a minimally invasive, readily repeatable procedure that can be used to ablate small tumors, preferably before patients become severely symptomatic, radiofrequency ablation can provide effective control of liver tumor volume in most patients over many years.

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References

  1. K Oberg (1993) ArticleTitleThe use of chemotherapy in the management of neuroendocrine tumors Endocrinol Metab Clin North Am 22 941 Occurrence Handle8125079

    PubMed  Google Scholar 

  2. R Chamberlain D Canes K Brown et al. (2000) ArticleTitleHepatic neuroendocrine metastases: does intervention alter outcomes? J Am Coll Surg 190 432–445 Occurrence Handle10.1016/S1072-7515(00)00222-2 Occurrence Handle10757381

    Article  PubMed  Google Scholar 

  3. B Eriksson B Skogseid G Lundquist et al. (1990) ArticleTitleMedical treatment and long term survival in a prospective study of 84 patients with endocrine pancreatic tumours Cancer 65 1883–1890 Occurrence Handle1695540

    PubMed  Google Scholar 

  4. M Chung J Pisegna M Spirt et al. (2001) ArticleTitleHepatic cytoreduction followed by a novel long-acting somatostatin analog: a paradigm for intractable neuroendocrine tumors metastatic to the liver Surgery 130 954–962 Occurrence Handle10.1067/msy.2001.118388 Occurrence Handle11742323

    Article  PubMed  Google Scholar 

  5. H Chen J Hardacre A Uzar et al. (1998) ArticleTitleIsolated liver metastases from neuroendocrine tumors: does resection prolong survival? J Am Coll Surg 187 88–93 Occurrence Handle10.1016/S1072-7515(98)00099-4 Occurrence Handle9660030

    Article  PubMed  Google Scholar 

  6. P Ruszniewski D Malka (2000) ArticleTitleHepatic arterial chemoembolization in the management of advanced digestive endocrine tumors Digestion 62 IssueIDsuppl 1 79–83 Occurrence Handle10.1159/000051860 Occurrence Handle10940692

    Article  PubMed  Google Scholar 

  7. A Roche B Girish T Baere Particlede et al. (2003) ArticleTitleTrans-catheter arterial chemoembolization as first-line treatment for hepatic metastases from endocrine tumours Eur Radiol 13 136–140 Occurrence Handle12541121

    PubMed  Google Scholar 

  8. P Rougier E Mitry (2000) ArticleTitleChemotherapy in the treatment of neuroendocrine malignant tumors Digestion 62 IssueIDsuppl 1 73–78 Occurrence Handle10.1159/000051859

    Article  Google Scholar 

  9. K Oberg (2000) ArticleTitleInterferon in the management of neuroendocrine GEP tumors Digestion 62 IssueIDsuppl 1 92–97 Occurrence Handle10.1159/000051862 Occurrence Handle10940694

    Article  PubMed  Google Scholar 

  10. R Arnold B Simon M Wied (2000) ArticleTitleTreatment of neuroendocrine GEP tumours with somatostatin analogues Digestion 62 IssueIDsuppl 1 84–91 Occurrence Handle10.1159/000051861 Occurrence Handle10940693

    Article  PubMed  Google Scholar 

  11. J Sarmiento G Heywood J Rubin et al. (2003) ArticleTitleSurgical treatment of neuroendocrine metastases to the liver: a plea for resection to increase survival J Am Coll Surg 197 29–37 Occurrence Handle10.1016/S1072-7515(03)00230-8 Occurrence Handle12831921

    Article  PubMed  Google Scholar 

  12. J Bomanji W Wong M Gaze et al. (2003) ArticleTitleTreatment of neuroendocrine tumours in adults with I131-MIBG (review) Clin Oncol 15 193–198 Occurrence Handle10.1016/S0936-6555(02)00273-X

    Article  Google Scholar 

  13. B Eriksson J Renstrup H Imam K Oberg (1997) ArticleTitleHigh-dose treatment with lanreotide of patients with advanced gastrointestinal tumors: clinical and biochemical effects Ann Oncol 8 1041–1044 Occurrence Handle10.1023/A:1008205415035 Occurrence Handle9402179

    Article  PubMed  Google Scholar 

  14. A Gillams W Lees (2002) ArticleTitleRadiofrequency ablation in patients with biliary obstruction, biliary stents or bilio-enteric anastomoses Radiology 225 IssueIDP 488

    Google Scholar 

  15. A Siperstein S Roger P Jamsem A Gitomirsky (1997) ArticleTitleLaparoscopic thermal ablation of hepatic neuroendocrine tumor metastases Surgery 122 1147–1155 Occurrence Handle10.1016/S0039-6060(97)90221-X Occurrence Handle9426432

    Article  PubMed  Google Scholar 

  16. E Berber N Flesher A Siperstein (2002) ArticleTitleLaparoscopic radiofrequency ablation of neuroendocrine liver metastases World J Surg 26 985–990 Occurrence Handle10.1007/s00268-002-6629-5 Occurrence Handle12016479

    Article  PubMed  Google Scholar 

  17. P Hellman S Ladjevardi B Skogseid et al. (2002) ArticleTitleRadiofrequency tissue ablation using cooled tip for liver metastases of endocrine tumors World J Surg 26 1052–1056 Occurrence Handle10.1007/s00268-002-6663-3 Occurrence Handle12016482

    Article  PubMed  Google Scholar 

  18. G Kaltsas J Mukherjee A Grossman (2001) ArticleTitleThe value of radiolabelled mibg and octreotide in the diagnosis and management of neuroendocrine tumours Ann Oncol 12 IssueIDsuppl 2 S47–S50 Occurrence Handle10.1023/A:1012436710878 Occurrence Handle11762352

    Article  PubMed  Google Scholar 

  19. M Olausson S Friman C Cahlin et al. (2002) ArticleTitleIndications and results of liver transplantation in patients with neuroendocrine tumours World J Surg 26 998–1004 Occurrence Handle10.1007/s00268-002-6631-y Occurrence Handle12016481

    Article  PubMed  Google Scholar 

  20. T Lehnert (1998) ArticleTitleLiver transplantation for metastatic neuroendocrine carcinoma: an analysis of 103 patients Transplantation 66 1307–1312 Occurrence Handle10.1097/00007890-199811270-00007 Occurrence Handle9846513

    Article  PubMed  Google Scholar 

  21. A Siperstein E Berber (2001) ArticleTitleCryoablation, percutaneous ethanol injection and radiofrequency ablation for treatment of neuroendocrine liver metastases World J Surg 25 696–696 Occurrence Handle10.1007/s00268-001-0015-6

    Article  Google Scholar 

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Gillams, A., Cassoni, A., Conway, G. et al. Radiofrequency ablation of neuroendocrine liver metastases—the Middlesex experience. Abdom Imaging 30, 435–441 (2005). https://doi.org/10.1007/s00261-004-0258-4

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