Radiofrequency ablation of neuroendocrine liver metastases

Excerpt

Tumors derived from hormone-producing cells have unique clinical features secondary to the production of biologically active substances, i.e., peptides or amines. The rare occurrence of these tumors allows few physicians to become thoroughly acquainted with the diagnosis and the surgical and medical treatments of these tumors. The wide variety of clinical symptoms and signs associated with these tumors further complicates their clinical management. These tumors may also refrain from secreting clinically functioning hormones and are then denoted nonfunctioning tumors. Endocrine tumors are usually highly differentiated and much more indolent than their highly malignant exocrine counterparts. The considerably better survival rate alters the indications for surgery, radical and palliative, and the indications and choices of medical treatment. For example, the expected 5-year survival rate for a patient with midgut carcinoid disease and liver metastases is approximately 50% [1, 2]. Survival rates have increased in the past 15 years, reflecting the development of novel bioactive drugs, the better control of endocrine syndromes, the increased use of effective antitumoral systemic therapy, and an increased awareness of these rare diseases that contributes to earlier diagnoses. Different local treatments for liver metastases have been introduced in the past decade, such as transarterial chemoembolization, radiofrequency radiation, and stereotactic radiation, which provide symptomatic and objective morphologic responses [2]. There is a vast accumulated experience that indicates the success of a combination of surgical and medical treatments of metastases [3]. …