61 - Freie Mitteilung
HPB II & general oncology
16. Mai 2019, 13:45 - 15:15, Bellavista 5, 6. OG
The role of microwave ablation as an alternative or adjunct to resection of neuroendocrine liver metastases
S. Perrodin, M. Renzulli, G. Beldi, M. Maurer, D. Candinas, C. Kim-Fuchs, A. Lachenmayer, Presenter: S. Perrodin (Bern)
Surgical resection of neuroendocrine tumor (NET) liver metastases has been proven to improve survival, but the benefit of microwave ablation (MWA) as a minimally invasive and tissue-sparing alternative to curative surgery or as a debulking procedure has yet to be assessed. We aim to present our center’s experience with surgery and/or MWA for NET liver metastases.
Retrospective study including all patients treated with MWA and/or surgical resection for NET liver metastases between 2000 and 2017. Follow-up consisted in 3-monthly CT, MRI or PET-CT according to the recommendation of the interdisciplinary conference.
A total of 47 patients with a median age of 60 (27-76) were included in this analysis, receiving 68 interventions. Patients underwent between 1 and 4 interventions, including 34 liver resections (6 laparoscopic, 28 open), 20 MWAs (12 percutaneous stereotactic, 8 open), and 14 combined procedures (3 laparoscopic, 11 open). A total of 130 individual lesions were treated with MWA, representing 4 lesions per session (1-30). While no complications occurred after MWA, 9 patients needed drainage for 8 biliomas and 1 abscess (IIIa) and 1 patient was transplanted because of liver failure (IVb) after open resection. The majority of patients (33/47, 70.2%) received curative, procedures, 14 patients (29.8%) debulking procedures. Simultaneous resection of the primary tumor was performed in 27.9% (19/68) of the interventions. Two patients (4.3%) had a local recurrence at the site of ablation, in both cases combined with an overall disease progression in the liver. One patient (2.1%) had a recurrence at the site of resection and underwent successful re-resection. Liver-only disease progression was detected in 17% of the patients and overall progression in 47%, and occurred after median 7 months (range 0-43). The mean survival was not significantly different between the debulking and curative group (38.9 months (SD 20.1) and 50.8 months (SD 38.8) respectively, p=0.2288).
MWA might be a safe alternative or additition to resection for NET liver metastases with low complication and local recurrence rates, allowing a liver-sparing minimal invasive treatment of this often recurring chronic disease.