Erschienen in:
30.05.2019 | ASO Author Reflections
ASO Author Reflections: Immediate Fluorescent Tissue Assessment—The ‘Frozen Section’ for Tumor Ablation?
verfasst von:
Vlasios S. Sotirchos, MD, Constantinos T. Sofocleous, MD, PhD, FSIR, FCIRSE
Erschienen in:
Annals of Surgical Oncology
|
Sonderheft 3/2019
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Excerpt
During the surgical management of hepatic tumors, the resection margins are routinely assessed with pathology. The presence of positive margins allows extension of resection if feasible, or timely administration of adjuvant treatments, either in the form of chemotherapy, repeat resection, or other local treatment. In contrast, tissue is not available for examination after tumor ablation. Therefore, the ablation margins are estimated using imaging, either anatomic and/or metabolic.
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2 However, a scenario often encountered in clinical practice is tumor recurrence after ablation despite radiographic evidence of adequate margins. To further evaluate this phenomenon and to address the limitation of tissue unavailability, a previous study from our group assessed the ablation zone of colorectal liver metastases with immediate post-procedural biopsies, showing that viable tumor cells can be found in ablation zones radiographically considered adequate. The presence of these cells was an independent predictor of shorter local progression-free survival.
3 It is possible that these tumor cells survive the initial insult, remain quiescent for a variable period of time, and lead to local progression. Identification of these patients at risk would allow administration of adjuvant treatments, similar to surgery. …
