scholarly journals Microwave ablation in the treatment of liver tumors. A better tool or simply more power?

2020 ◽  
Vol 22 (4) ◽  
pp. 451
Author(s):  
Zeno Sparchez ◽  
Tudor Mocan ◽  
Pompilia Radu ◽  
Iuliana Nenu ◽  
Mihai Comsa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Liver Metastases ◽  
Intrahepatic Cholangiocarcinoma ◽  
Thermal Ablation ◽  
Microwave Ablation ◽  
Liver Tumors ◽  
Colorectal Cancer Liver Metastases ◽  
Clinical Scenarios

It has been a long time since tumor ablation was first tested in patients with liver cancer, especially hepatocellular carcinoma. Since than it has become a first line treatment modality for hepatocellular carcinoma. Over the years, the indications of thermal ablation have expanded to colorectal cancer liver metastases and intrahepatic cholangiocarcinoma as well. Together with the new indication for ablation, new ablation devices have been developed as well. Among them microwave ablation shows potential in replacing radiofrequency ablation as the preferred method of thermal ablation in liver cancer. The debate whether radiofrequency or microwave ablation should be the preferred method of treatment in patients with liver cancer remains open. The main purpose of this review is to offer some answers to the question: Microwave ablation in liver tumors: a better tool or simply more power? Various clinical scenarios will be analyzed including small, medium, and intermediate size hepatocellular carcinoma, colorectal cancer liver metastases and intrahepatic cholangiocarcinoma. Furthermore, the advantages, limitations, and technical considerations of MWA treatment will be provided also.

scholarly journals A Retrospective Study of Lenvatinib Monotherapy or Combined With Programmed Cell Death Protein 1 Antibody in the Treatment of Patients With Hepatocellular Carcinoma or Intrahepatic Cholangiocarcinoma in China

2021 ◽  
Vol 11 ◽  
Author(s):  
Sihui Zhu ◽  
Chenxi Liu ◽  
Yanbing Dong ◽  
Jie Shao ◽  
Baorui Liu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cell Death ◽  
Liver Cancer ◽  
Programmed Cell Death ◽  
Intrahepatic Cholangiocarcinoma ◽  
Real World ◽  
Liver Tumors ◽  
Chinese Patients ◽  
First Line ◽  
Cell Death Protein

Lenvatinib has been ratified as a first-line medication for advanced liver tumors by the American Food and Drug Administration. To assess the effectiveness and security of Lenvatinib in the Chinese population in a real-world setting, we enrolled 48 patients with unresectable liver cancer, managed from December 2018 to March 2021. Among them, 9 and 39 (83.30% men) patients had intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC), respectively. Twenty-one (43.75%) patients had progressive disease after first-line treatment, and others (56.25%) had not receiving systemic treatment. Lenvatinib was administered alone or in combination with a programmed cell death protein 1 antibody (anti-PD-1). Treatment duration, median progression-free survival (mPFS), and median overall survival (mOS) were examined. The mOS and mPFS were 22.43 and 8.93 months, respectively. Of HCC patients treated with Lenvatinib only, the mOS and mPFS were 22.43 and 11.60 months, respectively. The corresponding values for HCC cases managed with anti-PD-1 combined with Lenvatinib were 21.77 and 7.10 months, respectively. ICC patients did not reach the mOS and their mPFS was 8.63 months. The present findings support the efficacy and security of Lenvatinib in the real-world therapy of Chinese patients with unresectable liver cancer.

Simultaneous resection of colorectal cancer with synchronous liver metastases: A survey-based analysis.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 662-662
Author(s):  
Christopher Griffiths ◽  
Jessica Bogach ◽  
Marko Simunovic ◽  
Leyo Ruo ◽  
Julie I. Hallet ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Low Complexity ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Colorectal Cancer Liver Metastases ◽  
Simultaneous Resection ◽  
Clinical Scenarios ◽  
General Surgeons ◽  
Colorectal Resections

662 Background: Decision to proceed with simultaneous or staged resection in synchronous colorectal cancer liver metastases (CRLM) varies and is usually left to the individual surgeon. We examined practice intentions and barriers to performing simultaneous resection. Methods: We developed and pilot-tested a tailored questionnaire. Members of the Society of Surgical Oncology and the College of Physicians and Surgeons of Ontario operating colorectal cancer were surveyed electronically. Four clinical scenarios of synchronous CRLM determined practice intentions for varying degrees of complexity. Perceived barriers were assessed on a 7-point Likert scale. We compared general and hepatobiliary surgeons’ responses with Mann-Whitney U test for continuous variables and Chi-square test for categorical variables. Results: There were 184/1,335 surgeons (14% response rate), including 50 general and 134 hepatobiliary surgeons. Both were supportive of simultaneous resection, though hepatobiliary surgeons were more so; for minor liver and low complexity colorectal resections (Likert ≥5-7: 83% vs. 98% p<0.001), or for complex colorectal resections (57% vs. 73% p=0.042). Both groups were less supportive of simultaneous resection for complex liver with low complexity (Likert ≥5-7: 26% vs. 24% respectively, p=0.858) or high complexity colorectal resections (11% vs. 7.0% respectively, p=0.436). All perceived that simultaneous resection increases post-operative morbidity (63%), but not mortality (69%). Among hepatobiliary surgeons, the most common barriers for simultaneous resections were comorbidities and extrahepatic disease, whereas general surgeons were more concerned about transfer to another facility. Conclusions: While general and hepatobiliary surgeons are supportive of simultaneous resection, especially for less complex liver resections; support is significantly lower among general surgeons. In addition to complexity of procedures and perceived morbidity, the need for transfer of care appears as a barrier to simultaneous resections. The practice intentions and barriers described are important to identify knowledge gaps, guide future trials, and establish disease care pathways.

Survival after Yttrium-90 radioembolization in elderly and nonelderly patients with hepatocellular carcinoma or colorectal cancer liver metastases.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 449-449
Author(s):  
Rebecca Ann Redman ◽  
Douglas Coldwell ◽  
Vivek R. Sharma
Keyword(s):  
Colorectal Cancer ◽  
Hepatocellular Carcinoma ◽  
Liver Metastases ◽  
Surgical Resection ◽  
Median Survival ◽  
The Elderly ◽  
Curative Intent ◽  
Colorectal Cancer Liver Metastases ◽  
Younger Patients ◽  
Yttrium 90

449 Background: Systemic treatment of unresectable hepatocellular carcinoma (HCC) or colorectal cancer liver metastases (CLM) in the elderly can be complicated by increased toxicity. In addition, the increasing incidence of comorbidities with age may preclude surgical resection with curative intent. Hepatic arterial therapy is increasingly utilized in patients with HCC or CLM not amenable to surgical resection. Studies of transarterial chemoembolization in the elderly have generally shown similar safety and efficacy as compared to younger patients, although some studies suggest worse outcomes. The selective nature of radioembolization has the potential for improved tolerability in this patient population. Methods: We report the results of a retrospective review of patients with unresectable HCC or metastatic disease to the liver treated with Yttrium-90 radioembolization at a single institution. Results: Patients were referred for treatment after multidisciplinary evaluation, but were not treated as part of a clinical trial. A total of 94 patients treated were evaluable for follow up. There were approximately twice as many males as females (64% vs 36%). Elderly was defined as 70 years of age or older, representing 20 of the 94 patients. Average age of the elderly cohort was 76 (range 70-90), compared to 56 years of age (range 23-69) for the younger patients. Survival was measured from date of first radioembolization. Median survival was similar for elderly and younger patients when considering all tumor types (337 days vs 288 days). There was no difference in median survival between elderly and non-elderly patients with CLM (377 days vs 365 days) or with HCC (370 days vs 363 days). Conclusions: In our experience, survival after Yttrium-90 radioembolization in elderly and younger patients with primary HCC or CLM is similar. Age alone should not preclude consideration for liver-directed therapy.

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