Sitzung

61 - Freie Mitteilung
HPB II & general oncology
16. Mai 2019, 13:45 - 15:15, Bellavista 5, 6. OG

Abstract

1
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)

Ziel
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.
Methoden
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.
Resultate
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).
Schlussfolgerung
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.
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