Ultrasound ablation for metastatic liver cancer and unresectable pancreatic tumors

Material and methods. Ultrasound ablation has been performed in 165 patients with metastatic liver cancer (metastases of colorectal cancer as a rule) and in 17 patients with unresectable pancreatic neoplasms for the period from April 2009 to December 2017. All patients with metastatic liver cancer underwent previous surgery for primary tumor. In 53% of cases unresectable pancreatic tumor was complicated by mechanical jaundice that required biliary drainage and stenting before ablation. Ultrasound and contrast-enhanced CT were applied to assess changes of tumor dimensions, its structure compared with initial data, vascularization grade, continued growth or de novo metastases with positive changes within destruction area. Percutaneous biopsy of liver and pancreatic tumors was carried out in 136 patients (75%) to assess morphological changes of tumor in pre- and postoperative period. Results. There were no intra – and postoperative complications. Three types of changes occurring within destruction area were revealed. Positive changes including changes of tumor structure, reduced dimensions and volume were observed in 76 (46%) patients. 38 (23%) patients had either augmentation of dimensions and volume of destruction area or appearance of additional tumor tissue on the periphery of metastasis. De novo liver metastases or other distant ones occurred in 51 (31%) patients with positive changes in destruction area. Oncologists of our center evaluated immediate and long-term outcomes of combined treatment. Reduced tumor dimension on the background of mild or absent pain syndrome were confirmed in 12 (72%) patients after ablation of pancreatic tumor. In 8 out of 12 patients weight gain and absent pain syndrome were observed within 48 months. Conclusion. Ultrasound ablation is effective and safe for local destruction of secondary liver tumors and unresectable pancreatic tumors. This approach is indicated for inoperable cases and as a stage of combined treatment.

liver, pancreas, secondary liver tumors, metastasis, ultrasound ablation, minimally invasive technologies

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