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Erschienen in: Journal of Gastrointestinal Surgery 4/2017

23.11.2016 | Original Article

Planned Treatment of Advanced Metastatic Disease with Completion Ablation After Hepatic Resection

verfasst von: Bruno C. Odisio, Suguru Yamashita, Livia Frota, Steven Y. Huang, Scott E. Kopetz, Kamran Ahrar, Yun Shin Chun, Thomas A. Aloia, Marshall E. Hicks, Sanjay Gupta, Jean-Nicolas Vauthey

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 4/2017

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Abstract

Purpose

The aim of this study is to describe a modified treatment strategy with image-guided percutaneous ablation after hepatic resection as a completion method to surgical eradication of liver metastases (“completion ablation [CA]”).

Methods

We conducted a retrospective analyses of patients who underwent CA within 180 days from the liver surgical resection to eradicate liver metastases present on the pre-surgical cross-sectional imaging or identified during intraoperative ultrasound that were not resected due to various reasons. Lesions treated with CA were evaluated for local tumor progression (LTP). Patients were evaluated for hepatic- and overall-recurrence-free survivals (hepatic-RFS and overall-RFS, respectively) and overall survival (OS).

Results

Sixteen patients (10 females; median age 55 years, range 28–69) underwent CA of 21 lesions (median size 8 mm, range 6 to 22). Indications for the use of CA were small future liver remnant in 10 (63%), inability to identify the lesion during surgical exploration in 3 (19%), and technical difficulty of resection in 3 (19%) patients. No liver-related complications were recorded following the surgical resection or the CA procedures. Primary and secondary CA efficacy rates were 95 and 100%, respectively. LTP was 0% at a median clinical follow-up of 27 months (range 4.0–108 months). Five-year hepatic-RFS, overall-RFS, and OS were 36, 16, and 51%, respectively.

Conclusion

The use of CA as a complement to surgical resection is safe and effective. Such approach could potentially expand the surgical candidacy for patients with limited liver functional reserve and reduce postoperative morbidity and mortality in this selected patient population with more advanced disease.
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Metadaten
Titel
Planned Treatment of Advanced Metastatic Disease with Completion Ablation After Hepatic Resection
verfasst von
Bruno C. Odisio
Suguru Yamashita
Livia Frota
Steven Y. Huang
Scott E. Kopetz
Kamran Ahrar
Yun Shin Chun
Thomas A. Aloia
Marshall E. Hicks
Sanjay Gupta
Jean-Nicolas Vauthey
Publikationsdatum
23.11.2016
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 4/2017
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-016-3324-7

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