RFA for liver mets from breast cancer – pro

Percutaneous radio-frequency (RF) ablation for the treatment of focal liver cancer is a relatively new image-guided procedure that is rapidly gaining acceptance in the radiologic and surgical community, particularly as therapy for patients who have inoperable tumors. This procedure is being rapidly adopted in favor of other minimally invasive therapies, such as percutaneous ethanol injection (PEI), and in some cases, it is chosen over surgery because of its potential benefits, including reduced morbidity and mortality. Further, its potential use in the treatment of patients who are not candidates for surgery is particularly important. Although findings in encouraging preliminary reports suggest that this procedure is both safe and effective, thus far results in only a limited number of studies in which this technology was assessed have been published.

National Comprehensive Cancer Network (NCCN, 2007) hepatocellular carcinoma guidelines state that microwave ablation, cryotherapy, radiofrequency ablation, and percutaneous ethanol injection may be used in the treatment of unresectable nonmetastatic hepatocellular carcinoma, for patients with nonmetastatic hepatocellular carcinoma who do not agree to surgery, and to treat hepatocellular carcinoma which is local but inoperable (e.g,, due to poor performance status or presence of comorbidity). NCCN guidelines make no distinction with respect to these different ablative methods. NCCN guidelines state that ablative therapy of colorectal cancer metastases to the liver using radiofrequency ablation or cryosurgery at the time of colon resection can also be considered when all measurable metastatic disease can be treated.

The goal of RFA is local control and prevention of farther spread. Breast cancer is different than colon cancer in its patterns of spread and natural history. There are no large studies decribing the ultimate effect of RFA on these factors in breast cancer. Therefore, it should be consdered experimental at this time, especially after chemotherapy.

nccn.org 2018

here is no evidencen that RFA increases survival pr progression free survival for prostate cancer. Percutaneous radio-frequency (RF) ablation for the treatment of focal liver cancer is a relatively new image-guided procedure that is rapidly gaining acceptance in the radiologic and surgical community, particularly as therapy for patients who have inoperable tumors. This procedure is being rapidly adopted in favor of other minimally invasive therapies, such as percutaneous ethanol injection (PEI), and in some cases, it is chosen over surgery because of its potential benefits, including reduced morbidity and mortality. Further, its potential use in the treatment of patients who are not candidates for surgery is particularly important. Although findings in encouraging preliminary reports suggest that this procedure is both safe and effective, thus far results in only a limited number of studies in which this technology was assessed have been published.

National Comprehensive Cancer Network (NCCN, 2007) hepatocellular carcinoma guidelines state that microwave ablation, cryotherapy, radiofrequency ablation, and percutaneous ethanol injection may be used in the treatment of unresectable nonmetastatic hepatocellular carcinoma, for patients with nonmetastatic hepatocellular carcinoma who do not agree to surgery, and to treat hepatocellular carcinoma which is local but inoperable (e.g,, due to poor performance status or presence of comorbidity). NCCN guidelines make no distinction with respect to these different ablative methods. NCCN guidelines state that ablative therapy of colorectal cancer metastases to the liver using radiofrequency ablation or cryosurgery at the time of colon resection can also be considered when all measurable metastatic disease can be treated.

nccn.org 2018

Ng KM, Chua TC, Saxena A, et al. Two decades of experience with hepatic cryotherapy for advanced
colorectal metastases. Ann Surg Oncol. Apr 2012;19(4):1276-1283.

http://publications.nice.org.uk/radiofrequency-ablation-for-colorectal-liver-metastases-ipg327, 2012

Malignant Liver Tumors: Treatment with Percutaneous Microwave Ablation–Complications among Cohort of 1136 Patients1 Radiology June 1, 2009 251:3 933-940

Gervais DA, Goldberg SN, Brown DB et al. Society of Interventional Radiology position statement on percutaneous radiofrequency ablation for the treatment of liver tumors. J Vasc Interv Radiol 2008;

 

http://publications.nice.org.uk/radiofrequency-ablation-for-colorectal-liver-metastases-ipg327, 2012

Malignant Liver Tumors: Treatment with Percutaneous Microwave Ablation–Complications among Cohort of 1136 Patients1 Radiology June 1, 2009 251:3 933-940

31.Gervais DA, Goldberg SN, Brown DB et al. Society of Interventional Radiology position statement on percutaneous radiofrequency ablation for the treatment of liver tumors. J Vasc Interv Radiol 2008;

Sutherland LM, Williams JA, Padbury RT, Gotley DC, Stokes B, Maddern GJ.Radiofrequency ablation of liver tumors: a systematic review. Arch Surg. 2006 Feb;141(2):181-90.

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