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Is RF Ablation In Treatment Of Liver Metastasis Feasible?
Question: Can ablation get rid of small mets ?
Brief Answer:
Survival prolonged if metastasis smaller than 3 cm and lesser than 3
Detailed Answer:
Hi XXXX,
Thanks for writing in.
I have read through your query in detail.
It appears to me that you are inquiring about the feasibility of radio frequency ablation in treatment of liver metastasis from colon cancer.
There are certain patterns followed by liver metastasis when treated by RF ablation. It is said that if the metastasis is more than 3 cm in size then the probability of new metastasis is higher after RF ablation.
In a study involving treating 117 patients with 179 liver metastases with RF ablation, Most patients (88%) had fewer than 3 lesions, with a median
lesion size of 2.6 cm. A median survival of 36 months was achieved.
So if the size of metastasis is smaller than 3 cm and they are below 3 in number then the survival chances are prolonged by more than 3 years.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Survival prolonged if metastasis smaller than 3 cm and lesser than 3
Detailed Answer:
Hi XXXX,
Thanks for writing in.
I have read through your query in detail.
It appears to me that you are inquiring about the feasibility of radio frequency ablation in treatment of liver metastasis from colon cancer.
There are certain patterns followed by liver metastasis when treated by RF ablation. It is said that if the metastasis is more than 3 cm in size then the probability of new metastasis is higher after RF ablation.
In a study involving treating 117 patients with 179 liver metastases with RF ablation, Most patients (88%) had fewer than 3 lesions, with a median
lesion size of 2.6 cm. A median survival of 36 months was achieved.
So if the size of metastasis is smaller than 3 cm and they are below 3 in number then the survival chances are prolonged by more than 3 years.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok wondering about a new procedure called nano knife ( you may not have heard of it).
My after has a liver met 19 mm, a node 12 mm, 1 sub pleural nodule at 0.5 cm.
Problem is irinotecan as started but did not work . So the dr saying we can't do further treatment as chemo
Resistant .
How can the micro mets be controlled ? Also if has nano knife etc , that will
Not stop further mets right ?
My after has a liver met 19 mm, a node 12 mm, 1 sub pleural nodule at 0.5 cm.
Problem is irinotecan as started but did not work . So the dr saying we can't do further treatment as chemo
Resistant .
How can the micro mets be controlled ? Also if has nano knife etc , that will
Not stop further mets right ?
Brief Answer:
Nanoknife is a promising technique
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
The Nanoknife Irreversible Electroporation, or IRE, works by using electrical energy to directly target tumors on the cellular level. IRE destroys tumors using intense bursts of electricity while leaving healthy tissues of the body unharmed.
This is a safer technique than RF ablation. While the 19 mm metastasis will be treated inutially, smaller ones can also be subsequently should they appear later. Nanoknife will be promising in trying to control the 19 mm lesion. Appearance of new lesions is a matter of probability. With present statistics your father should be doing well if the liver metastasis responds to treatment with nanoknife.
Controlling micromets is a concern only when it happens. Till then let us try treatment the single one in his liver which will respond well to nanoknife given its size.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Nanoknife is a promising technique
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
The Nanoknife Irreversible Electroporation, or IRE, works by using electrical energy to directly target tumors on the cellular level. IRE destroys tumors using intense bursts of electricity while leaving healthy tissues of the body unharmed.
This is a safer technique than RF ablation. While the 19 mm metastasis will be treated inutially, smaller ones can also be subsequently should they appear later. Nanoknife will be promising in trying to control the 19 mm lesion. Appearance of new lesions is a matter of probability. With present statistics your father should be doing well if the liver metastasis responds to treatment with nanoknife.
Controlling micromets is a concern only when it happens. Till then let us try treatment the single one in his liver which will respond well to nanoknife given its size.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
19 mm not big right ?I've uploaded new and old ct report . The only new met is the sub pleural one right ?
My worry is what to do if more mets appear without chemo ?what if after nano more mets appear ? As from august in January 1 extra met appeared u will see
My worry is what to do if more mets appear without chemo ?what if after nano more mets appear ? As from august in January 1 extra met appeared u will see
Brief Answer:
Doctors might prefer nanoknife for new lesions in liver
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I have seen through the old report. At that time the metastasis lesion in segment 6 of liver measured 15 x 22 mm. If this has not grown much in size since the last CT scan then nanoknife can treat such lesions. I understand your concern about the future appearance of new lesions. In cancer treatment, there is a little amount of uncertainty and all measures are taken to eliminate any potential threat of disease progression as much possible. Nanoknife utility is a promising one and current data suggests treating doctors are preferrring to treat new lesions with it should a patient have any. Please remember the earlier lesion is chemotherapy resistant and your doctors are not left with much choice in treating the liver metastasis.
The sub pleural emtastasis detail is not mentioned in the report above and that is also important to review in follow up CT scan.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Doctors might prefer nanoknife for new lesions in liver
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I have seen through the old report. At that time the metastasis lesion in segment 6 of liver measured 15 x 22 mm. If this has not grown much in size since the last CT scan then nanoknife can treat such lesions. I understand your concern about the future appearance of new lesions. In cancer treatment, there is a little amount of uncertainty and all measures are taken to eliminate any potential threat of disease progression as much possible. Nanoknife utility is a promising one and current data suggests treating doctors are preferrring to treat new lesions with it should a patient have any. Please remember the earlier lesion is chemotherapy resistant and your doctors are not left with much choice in treating the liver metastasis.
The sub pleural emtastasis detail is not mentioned in the report above and that is also important to review in follow up CT scan.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
the subplural nodule is a met , why the report says nodule and not metastases?
also the adrenal gland one , although says new, seems to be the one in previous report right? in previous report was benign.
what you think re survival in this particular case?
also the adrenal gland one , although says new, seems to be the one in previous report right? in previous report was benign.
what you think re survival in this particular case?
Brief Answer:
Please attach latest report
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I am able to see only one report attached in this query the 247-08-2014 report.
The left adrenal nodule is described as small. The report says nodule and not metastases because it might be small to say with certainty at that time.
There is no sub pleural nodule in the report.
Please attach the latest report also to get a better idea and then I can make an estimation on survival after knowing the growth of adrenal and the appearance of chest nodule.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please attach latest report
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
I am able to see only one report attached in this query the 247-08-2014 report.
The left adrenal nodule is described as small. The report says nodule and not metastases because it might be small to say with certainty at that time.
There is no sub pleural nodule in the report.
Please attach the latest report also to get a better idea and then I can make an estimation on survival after knowing the growth of adrenal and the appearance of chest nodule.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
New report sent . This one is XXXXXXX 2015.
I'm querying re the adrenal
Gland as that was also in previous report on left side.
Also the sub pleural lobe nodule .
Do nodules mean mets. ?
I'm querying re the adrenal
Gland as that was also in previous report on left side.
Also the sub pleural lobe nodule .
Do nodules mean mets. ?
Brief Answer:
Nodules in cancer patients are most likely metastasis
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. A nodule in the lung refers to a coin like lesion less than 3 cm in diameter. This definition is based on size and it can be a benign or malignant nodule depending on the condition. In a patient having cancer, a nodule is always taken as metastasis unless proven otherwise.
2. In the January 15 CT scan there is description of
(i) New subpleural nodule in left lower lobe
(ii) Another new nodule in posterior segment of right upper lobe.
These nodules show that the disease has spread to both lungs.
3. There is increase in aortocaval node and subcapsular liver lesions.
4. The adrenal nodule has been described as new and the size is not mentioned. This can be due to an increase in size from the previous CT scan. Any nodule in a patient with cancer is a metastasis unless proven otherwise.
In conclusion, the disease is seen to have spread to both lungs, left adrenal, liver and aortocaval node. This is a serious concern from treatment point of view. The five-year survival rate for colon cancer found with metastasis is 12%.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Nodules in cancer patients are most likely metastasis
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. A nodule in the lung refers to a coin like lesion less than 3 cm in diameter. This definition is based on size and it can be a benign or malignant nodule depending on the condition. In a patient having cancer, a nodule is always taken as metastasis unless proven otherwise.
2. In the January 15 CT scan there is description of
(i) New subpleural nodule in left lower lobe
(ii) Another new nodule in posterior segment of right upper lobe.
These nodules show that the disease has spread to both lungs.
3. There is increase in aortocaval node and subcapsular liver lesions.
4. The adrenal nodule has been described as new and the size is not mentioned. This can be due to an increase in size from the previous CT scan. Any nodule in a patient with cancer is a metastasis unless proven otherwise.
In conclusion, the disease is seen to have spread to both lungs, left adrenal, liver and aortocaval node. This is a serious concern from treatment point of view. The five-year survival rate for colon cancer found with metastasis is 12%.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
We have been told the following from the images viewed at the MDT:
Adrenal
Gland - not a metastases
Upper lobe ( which remains unchanged ) not a metastases
Sub pleural lobe nodule - metastases
Liver met is only 1 , there is a typing error as radiologist said metastases.
So 3 altogether ... 1 liver met, 1 node and 1 sub pleural
Node.
Should we proceed with nano knife ?
Adrenal
Gland - not a metastases
Upper lobe ( which remains unchanged ) not a metastases
Sub pleural lobe nodule - metastases
Liver met is only 1 , there is a typing error as radiologist said metastases.
So 3 altogether ... 1 liver met, 1 node and 1 sub pleural
Node.
Should we proceed with nano knife ?
Brief Answer:
Nanoknife can stabilize the liver lesion
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Nanoknife is a new technique and still research is going on in this area.
For cancer with liver metastasis, research on 12 patients has been done in Australia
Following results have been found after using this method of treatment
1. Liver metastases larger than 5 cm in any dimension showed no response in terms of tumor control.
2. IRE (nanoknife) response rate in liver metastases was 50% but all patients in this group showed progressive disease from other lesions.
3. Outcome of the 45 procedures performed in 12 patients with liver metastases showed the following
Complete response in 19 patients
Progressive disease in 2 paatients
Stable disease in 6 patients
The response was studied 3 months after treatment.
Therefore treatment with nanoknife can be thought of since the liver metastasis is non responsive to chemotherapy.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Nanoknife can stabilize the liver lesion
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Nanoknife is a new technique and still research is going on in this area.
For cancer with liver metastasis, research on 12 patients has been done in Australia
Following results have been found after using this method of treatment
1. Liver metastases larger than 5 cm in any dimension showed no response in terms of tumor control.
2. IRE (nanoknife) response rate in liver metastases was 50% but all patients in this group showed progressive disease from other lesions.
3. Outcome of the 45 procedures performed in 12 patients with liver metastases showed the following
Complete response in 19 patients
Progressive disease in 2 paatients
Stable disease in 6 patients
The response was studied 3 months after treatment.
Therefore treatment with nanoknife can be thought of since the liver metastasis is non responsive to chemotherapy.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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