AIM: The aim of this study was to report the feasibility and early survival results of liver metastases (LM) resection combining cytoreductive surgery and radiofrequency ablation (RFA) during a one-step procedure, in patients presenting more than 15 bilateral LM from well-differentiated endocrine carcinoma. It is an extensive application of the current guidelines. METHODS: In this retrospective review of a prospectively collected database, we used a combination of hepatectomy to treat large or contiguous LM, and extensively used multiple RFA to treat the remaining LM which were smaller than 2.5 cm. Patients were selected based on a low natural tumor burden slope, and the technical feasibility of treating all the detectable LM. RESULTS: From January 2002 to May 2007, 16 patients with a median of 23 LM per patient (mean number: 25.7 + or -12; range16-89) underwent this procedure. A mean of 15 + or - 9 LM per patient were surgically removed and a mean of 12 + or - 8 (median of 10) LM per patient were RF ablated. No mortality occurred. Morbidity was observed in 11 patients (69%). The 3-year overall survival and disease-free survival rates were similar to those observed in our preliminary series of 47 hepatectomized patients with a median of 7 LM per patient. CONCLUSION: This new one-step combined technique allowed us to apply an "upgraded" therapeutic approach to a selection of patients presenting a median of 23 LM per patient and to improve their prognosis, putting it on par with that obtained by conventional hepatectomy.
AIM: The aim of this study was to report the feasibility and early survival results of liver metastases (LM) resection combining cytoreductive surgery and radiofrequency ablation (RFA) during a one-step procedure, in patients presenting more than 15 bilateral LM from well-differentiated endocrine carcinoma. It is an extensive application of the current guidelines. METHODS: In this retrospective review of a prospectively collected database, we used a combination of hepatectomy to treat large or contiguous LM, and extensively used multiple RFA to treat the remaining LM which were smaller than 2.5 cm. Patients were selected based on a low natural tumor burden slope, and the technical feasibility of treating all the detectable LM. RESULTS: From January 2002 to May 2007, 16 patients with a median of 23 LM per patient (mean number: 25.7 + or -12; range16-89) underwent this procedure. A mean of 15 + or - 9 LM per patient were surgically removed and a mean of 12 + or - 8 (median of 10) LM per patient were RF ablated. No mortality occurred. Morbidity was observed in 11 patients (69%). The 3-year overall survival and disease-free survival rates were similar to those observed in our preliminary series of 47 hepatectomized patients with a median of 7 LM per patient. CONCLUSION: This new one-step combined technique allowed us to apply an "upgraded" therapeutic approach to a selection of patients presenting a median of 23 LM per patient and to improve their prognosis, putting it on par with that obtained by conventional hepatectomy.
Authors: Riccardo Memeo; Vito de Blasi; René Adam; Diane Goéré; Daniel Azoulay; Ahmet Ayav; Emilie Gregoire; Reza Kianmanesh; Francis Navarro; Antonio Sa Cunha; Patrick Pessaux Journal: HPB (Oxford) Date: 2016-07-05 Impact factor: 3.647
Authors: Skye C Mayo; Joseph M Herman; David Cosgrove; Nik Bhagat; Ihab Kamel; Jean-Francois H Geschwind; Timothy M Pawlik Journal: J Am Coll Surg Date: 2012-10-11 Impact factor: 6.113
Authors: Jessica E Maxwell; Scott K Sherman; Thomas M O'Dorisio; Andrew M Bellizzi; James R Howe Journal: Surgery Date: 2015-10-09 Impact factor: 3.982