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Eradication of Missing Liver Metastases After Fiducial Placement

Journal of Gastrointestinal Surgery volume 20, pages 1173–1178 (2016)Cite this article

Abstract

Background

The risk of colorectal liver metastases (CLM) disappearing on cross-sectional imaging has increased with advances in preoperative chemotherapy, but <50 % of disappearing CLM demonstrate complete pathological response.

Objective

The aim of this study was to evaluate the role of fiducial marker placement before potentially curative treatment of CLM at risk of disappearing with chemotherapy.

Methods

All consecutive patients who underwent fiducial placement for tracking of CLM at a tertiary center were reviewed.

Results

Among 1377 patients undergoing CLM resection between 2005 and 2015, 35 patients underwent fiducial placement. Three patients were excluded due to disease progression. The study population comprised 32 patients who underwent fiducial placement in 41 CLM. Among the 41 marked CLM, 34 (83 %) were located >10 mm deep in the liver parenchyma, 25 (61 %) were in the right liver, and median size was 12 mm (range, 6–20 mm). No complication occurred after fiducial placement. After chemotherapy, 19 (46 %) of the 41 marked metastases disappeared on cross-sectional imaging. All fiducial-tracked CLM were treated with resection (n = 31) or ablation (n = 10). After median follow-up of 14 months (range, 0–64 months), no local recurrences were observed.

Conclusion

Fiducial placement represents a safe procedure that facilitates accurate localization for resection or ablation of small CLM at risk of disappearing with chemotherapy.

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Acknowledgments

This research was supported, in part, by the National Institutes of Health through MD Anderson Cancer Center’s Support Grant, CA016672. Dr. Passot was supported by the French Association of Surgery.

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Affiliations

  1. Departments of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1484, Houston, TX, 77030, USA

    Guillaume Passot, Daria Zorzi, Bradford J. Kim, Suguru Yamashita, Claudius Conrad, Thomas A. Aloia, Jean-Nicolas Vauthey & Yun Shin Chun

  2. Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA

    Bruno C. Odisio, Armeen Mahvash, Sanjay Gupta & Michael J. Wallace

Authors
  1. Guillaume Passot
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  2. Bruno C. Odisio
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  3. Daria Zorzi
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  4. Armeen Mahvash
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  5. Sanjay Gupta
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  6. Michael J. Wallace
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  7. Bradford J. Kim
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  8. Suguru Yamashita
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  9. Claudius Conrad
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  10. Thomas A. Aloia
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  11. Jean-Nicolas Vauthey
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  12. Yun Shin Chun
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Corresponding author

Correspondence to Yun Shin Chun.

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Ethics Approval

The Institutional Review Board of the University of Texas MD Anderson Cancer Center approved this retrospective study (PA15-0366).

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Passot, G., Odisio, B.C., Zorzi, D. et al. Eradication of Missing Liver Metastases After Fiducial Placement. J Gastrointest Surg 20, 1173–1178 (2016). https://doi.org/10.1007/s11605-016-3079-1

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  • DOI: https://doi.org/10.1007/s11605-016-3079-1

Keywords

  • Fiducial
  • Disappearing liver metastases