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Vishwakarma M, Akram W, Haider T. Therapeutic mRNAs for cancer immunotherapy: From structure to delivery. Adv Immunol 2024; 165:163-197. [PMID: 40449973 DOI: 10.1016/bs.ai.2024.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2025]
Abstract
mRNA carries genetic information and is used for the synthesis of proteins, fragments of proteins, and peptides in the scope of biotechnology and medicine. Once introduced into cells, this mRNA gets translated into a corresponding protein with cellular machinery. All kinds of mRNA encoding any protein, peptide, and fragment of proteins have been designed to be used for various therapeutic goals, including cancerous diseases, immunotherapy, vaccine preparation, tissue engineering, and genetic disorders, among others. These vaccines encode tumor-specific antigens that stimulate the immune system to recognize and attack cancer cells. Additionally, mRNA can be designed to produce proteins that modulate immune checkpoints, thereby enhancing the immune system's ability to target cancer cells. Synthetic mRNA can also engineer immune cells, such as T cells, to improve their cancer-fighting capabilities. For instance, mRNA can be engineered to generate CAR T cells targeting specific antigens that are expressed in the cancer. Designed mRNA can encode functional proteins in patients suffering from genetic disorders characterized by an absence or defect in a particular protein. However, mRNA is intrinsically unstable and may require special mechanisms to protect it from degradation. mRNA delivery to target cells remains a challenge. Engineered nanocarriers containing mRNA can improve the efficiency and enable the delivery to specific sites, that can provide a stimulant or substance for therapeutic purposes. This combination may improve their stability and efficacy in multiple applications of therapies. The following chapter throws light on basic advances in mRNA-based cancer therapy and provides insights into the nanotherapeutics using mRNA in key preclinical developments and the evolving clinical landscape.
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Affiliation(s)
- Monika Vishwakarma
- Department of Pharmaceutical Sciences, Doctor Harisingh Gour University, Sagar, Madhya Pradesh, India; Faculty of Pharmacy, Kalinga University, Naya Raipur, Chhattisgarh, India
| | - Wasim Akram
- Amity Institute of Pharmacy, Amity University Madhya Pradesh, Gwalior, Madhya Pradesh, India.
| | - Tanweer Haider
- Gyan Vihar School of Pharmacy, Suresh Gyan Vihar University, Jaipur, Rajasthan, India.
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Rana JN, Mumtaz S, Han I, Choi EH. Harnessing the synergy of nanosecond high-power microwave pulses and cisplatin to increase the induction of apoptosis in cancer cells through the activation of ATR/ATM and intrinsic pathways. Free Radic Biol Med 2024; 225:221-235. [PMID: 39362289 DOI: 10.1016/j.freeradbiomed.2024.09.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 08/17/2024] [Accepted: 09/30/2024] [Indexed: 10/05/2024]
Abstract
The therapeutic application and dose of cisplatin are limited due to its toxicity to normal cells. Therefore, combination treatments might be the solution with a low dose of cisplatin. The combination effect of nanosecond pulsed high-power microwave (HPM) with cisplatin has not been investigated before. In this work, we aimed to investigate and assess the potential synergistic effects and most likely underlying mechanisms resulting from the combination of nanosecond pulsed HPM and cisplatin. Three cancer (SKOV3, H460, and MDA-MB231) and two normal (MRC5 and HGF) cell lines underwent separate treatments with HPM and cisplatin, as well as a combined treatment. A higher reduction of viability was observed in cancer cells using combination treatments following 24-h incubation. Cell death, membrane permeability, and intracellular reactive oxygen species (ROS) levels exhibit a noteworthy increase in response to combined 60 pulses of HPM (HPM60) and cisplatin (0.5 μM) treatments compared to control and individual treatments. Elevated γ-H2AX levels indicate DNA double-strand breaks in combined treatments. Additionally, upregulation of ATR/ATM, Chk1/Chk2, P53, and caspase 3/8, Bax, PARP, and Bcl2 confirms DNA damage and mitochondrial dysfunction, leading to apoptosis. Remarkably, half maximal inhibitory concentration (IC50) results showed that HPM60 and cisplatin (0.5 μM) resulted in 16 times higher cell death in SKOV3 and H460 cells compared to cisplatin alone. Moreover, the efficacy of this combined treatment led to an over 50 % decrease in the viability of cancer cells. On the other hand, normal cells (MRC5 and HGF) exhibited only a minor 3-5 % decrease in viability under the same treatment conditions. The obtained results elucidate the cellular mechanisms driving cell apoptosis/death, offering insights for potential advancements in cancer therapy through the combined application of nanosecond pulses of HPM and cisplatin. This serves as a first step for future investigations in this domain.
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Affiliation(s)
- Juie Nahushkumar Rana
- Department of Plasma Bio Display, Kwangwoon University, Seoul, South Korea; Plasma Bioscience Research Center (PBRC), Kwangwoon University, Seoul, South Korea
| | - Sohail Mumtaz
- Plasma Bioscience Research Center (PBRC), Kwangwoon University, Seoul, South Korea; Department of Electrical and Biological Physics, Kwangwoon University, Seoul, South Korea
| | - Ihn Han
- Department of Plasma Bio Display, Kwangwoon University, Seoul, South Korea; Plasma Bioscience Research Center (PBRC), Kwangwoon University, Seoul, South Korea
| | - Eun Ha Choi
- Department of Plasma Bio Display, Kwangwoon University, Seoul, South Korea; Plasma Bioscience Research Center (PBRC), Kwangwoon University, Seoul, South Korea; Department of Electrical and Biological Physics, Kwangwoon University, Seoul, South Korea.
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Biscaldi T, L'Huillier R, Milot L, N'Djin WA. Interstitial Dual-Mode Ultrasound With a 3-mm MR-Compatible Catheter for Image-Guided HIFU and Directional In Vitro Tissue Ablations. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:1588-1605. [PMID: 39259638 DOI: 10.1109/tuffc.2024.3458067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
Current interstitial techniques of tumor ablation face challenges that ultrasound (US) technologies could meet. The ablation radius and directionality of the US beam could improve the efficiency and precision. Here, a nine-gauge magnetic resonance (MR)-compatible dual-mode US catheter prototype was experimentally evaluated for ultrasound image-guided high-intensity focused ultrasound (USgHIFU) conformal ablations. The prototype consisted of 64 piezocomposite linear-array elements and was driven by an open research programmable dual-mode US platform. After verifying the US image guidance capabilities of the prototype, the high-intensity focused US (HIFU) output performances (dynamic focusing and HIFU intensities) were quantitatively characterized, together with the associated 3-D HIFU-induced thermal heating in tissue phantoms [using MR thermometry (MRT)]. Finally, the ability to produce robustly HIFU-induced thermal ablations in in vitro liver was studied experimentally and compared to numerical modeling. Investigations of several HIFU dynamic focusing allowed overcoming the challenges of miniaturizing the device: monofocal focusing maximized deep energy deposition, while multifocal strategies eliminated grating lobes. The linear-array design of the prototype made it possible to produce interstitial US images of tissue and tumor mimics in situ. Multifocal pressure fields were generated without grating lobes and transducer surface intensities reached up to . Seventeen elementary thermal ablations were performed in vitro. Rotation of the catheter proved the directionality of ablation, sparing nontargeted tissue. This experimental proof of concept demonstrates the feasibility of treating volumes comparable to those of primary solid tumors with a miniaturized USgHIFU catheter whose dimensions are close to those of tools traditionally used in interventional radiology while offering new functionalities.
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Cui H, Li J, Zheng K, Xu M, Zhang G, Hu Y, Yu X. Microwave-assisted intralesional curettage combined with other adjuvant methods for treatment of Campanacci III giant cell tumor of bone in distal radius: a multicenter clinical study. Front Oncol 2024; 14:1383247. [PMID: 38764573 PMCID: PMC11099234 DOI: 10.3389/fonc.2024.1383247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/18/2024] [Indexed: 05/21/2024] Open
Abstract
Objective To compare the clinical outcomes of microwave-assisted intralesional curettage(MAIC) with those of en bloc resection and autogenous fibular reconstruction (EBR-AFR) for treating grade III giant cell tumor of the bone (GCTB) of the distal radius and to elucidate the indications for wrist preservation surgery. Materials and methods In this retrospective study, 19 patients with grade III GCTB of the distal radius who underwent surgery at three medical institutions were included and categorized based on their surgical pattern. Seven patients underwent MAIC and internal fixation with bone cement (MAIC group) and 12 underwent EBR-AFR (EBR-AFR group). To evaluate the function of the affected limb postoperatively, wrist range of motion, grip strength, Musculoskeletal Tumor Society (MSTS) scores were recorded. Results The follow-up time of the MAIC group was 73.57 ± 28.61 (36-116) months, with no recurrence or lung metastasis. In contrast, the follow-up time of the EBR-AFR group was 55.67 ± 28.74 (36-132) months, with 1 case of local recurrence (8.3%, 1/12) and 1 case of lung metastasis (8.3%, 1/12). The wrist flexion, extension, supination, pronation, grip strength were better in the MAIC group than in the EBR-AFR group. Although there was no statistically significant difference in the MSTS score between the two groups, it is noteworthy that the MAIC group exhibited significantly superior emotional acceptance and hand positioning compared to the EBR-AFR group(p < 0.05). Conclusion The functional outcomes of the MAIC group are better. The treatment strategy for grade III GCTB of the distal radius should be determined based on the specific preoperative imaging findings. Nevertheless, MAIC can be the preferred surgical approach for most patients with grade III GCTB of the distal radius, particularly for young patients.
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Affiliation(s)
- Haocheng Cui
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Jianhua Li
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Kai Zheng
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Ming Xu
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
| | - Guochuan Zhang
- Department of Musculoskeletal Tumor, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yongcheng Hu
- Department of Bone Oncology, Tianjin Hospital, Tianjin, China
| | - Xiuchun Yu
- Orthopedic Department, 960 Hospital of People’s Liberation Army, Jinan, Shandong, China
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Daunizeau L, Nguyen A, Le Garrec M, Chapelon JY, N'Djin WA. Robot-assisted ultrasound navigation platform for 3D HIFU treatment planning: Initial evaluation for conformal interstitial ablation. Comput Biol Med 2020; 124:103941. [PMID: 32818742 DOI: 10.1016/j.compbiomed.2020.103941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/19/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
Interstitial Ultrasound-guided High Intensity Focused Ultrasound (USgHIFU) therapy has the potential to deliver ablative treatments which conform to the target tumor. In this study, a robot-assisted US-navigation platform has been developed for 3D US guidance and planning of conformal HIFU ablations. The platform was used to evaluate a conformal therapeutic strategy associated with an interstitial dual-mode USgHIFU catheter prototype (64 elements linear-array, measured central frequency f = 6.5 MHz), developed for the treatment of HepatoCellular Carcinoma (HCC). The platform included a 3D navigation environment communicating in real-time with an open research dual-mode US scanner/HIFU generator and a robotic arm, on which the USgHIFU catheter was mounted. 3D US-navigation was evaluated in vitro for guiding and planning conformal HIFU ablations using a tumor-mimic model in porcine liver. Tumor-mimic volumes were then used as targets for evaluating conformal HIFU treatment planning in simulation. Height tumor-mimics (ovoid- or disc-shaped, sizes: 3-29 cm3) were created and visualized in liver using interstitial 2D US imaging. Robot-assisted spatial manipulation of these images and real-time 3D navigation allowed reconstructions of 3D B-mode US images for accurate tumor-mimic volume estimation (relative error: 4 ± 5%). Sectorial and full-revolution HIFU scanning (angular sectors: 88-360°) could both result in conformal ablations of the tumor volumes, as soon as their radii remained ≤ 24 mm. The presented US navigation-guided HIFU procedure demonstrated advantages for developing conformal interstitial therapies in standard operative rooms. Moreover, the modularity of the developed platform makes it potentially useful for developing other HIFU approaches.
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Affiliation(s)
- L Daunizeau
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France.
| | - A Nguyen
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France
| | - M Le Garrec
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France
| | - J Y Chapelon
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France
| | - W A N'Djin
- LabTAU, INSERM, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003, Lyon, France
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Zheng K, Yu X, Hu Y, Zhang Y, Wang Z, Wu S, Shen J, Ye Z, Tu C, Zhang Y, Wei X, Hu Y, Wang X, Li J, Duan H, Wu Y, Xu M, Yuan Z, Wei Y, Chen B. Clinical Guideline for Microwave Ablation of Bone Tumors in Extremities. Orthop Surg 2020; 12:1036-1044. [PMID: 32776475 PMCID: PMC7454210 DOI: 10.1111/os.12749] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/08/2020] [Accepted: 06/18/2020] [Indexed: 02/05/2023] Open
Abstract
Microwave ablation has been used to treat bone tumors in extremities for more than 30 years. With improved recognition, updated microwave equipment, and expanded clinical application, microwave ablation has recently been widely used to treat bone tumors. To standardize the application of microwave ablation in the clinical treatment of bone tumors in the limbs, research results and clinical experience involving the use of microwave ablation to treat bone tumors in the limbs have been summarized, and a clinical guideline has been designed. This guideline is aimed at providing a reliable clinical basis for indications, preoperative evaluation and decision-making, perioperative treatment, complications, and other issues via evidence-based medicine. Two aspects are considered-percutaneous microwave ablation and intraoperative microwave ablation of bone tumors in extremities. Ultimately, the guideline is intended to standardize treatment and improve the clinical efficacy of microwave ablation of bone tumors in extremities.
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Affiliation(s)
- Kai Zheng
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Xiuchun Yu
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Yongcheng Hu
- Department of Bone OncologyTianjin HospitalTianjinChina
| | - Yingze Zhang
- Department of Orthopaedic SurgeryThe Third Hospital of Hebei Medical University, Orthopaedic Research Institute of Hebei ProvinceShijiazhuangChina
| | - Zhen Wang
- Department of Bone Oncology, Xijing HospitalAir Force Military Medical UniversityXi'anChina
| | - Sujia Wu
- Department of Orthopedics, School of Medicine, Jinling HospitalNanjing UniversityNanjingChina
| | - Jingnan Shen
- Department of Bone OncologyThe First Affiliated Hospital of Sun Yat Sen UniversityGuangzhouChina
| | - Zhaoming Ye
- Department of Orthopaedics, The Second Affiliated HospitalZhejiang University School of MedicineHangzhouChina
| | - Chongqi Tu
- Department of Orthopedics, West China HospitalSichuan UniversityChengduChina
| | - Yu Zhang
- Department of Orthopedics, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Xing Wei
- Department of OrthopedicsAerospace Center HospitalBeijingChina
| | - Yong Hu
- Department of Bone Disease and Bone Tumors Surgery, The First Affiliated HospitalAnhui Medical UniversityHefeiChina
| | - Xuquan Wang
- Department of OrthopedicsGuiqian International General HospitalGuiyangChina
| | - Jiazhen Li
- Department of OrthopaedicsThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Hong Duan
- Department of Orthopedics, West China HospitalSichuan UniversityChengduChina
| | - Yuxian Wu
- Department of Bone Oncology, Qilu Hospital (Qingdao), Cheeloo College of MedicineShandong UniversityQingdaoChina
| | - Ming Xu
- Department of OrthopedicsThe 960th Hospital of the PLA Joint Logistice Support ForceJinanChina
| | - Zhenchao Yuan
- Department of Bone and Soft Tissue SurgeryGuangxi Medical University Cancer HospitalNanningChina
| | - Yongzhong Wei
- Department of OrthopaedicsThe First Affiliated Hospital With Nanjing Medical UniversityNanjingChina
| | - Bingyao Chen
- Department of OrthopedicsGuiqian International General HospitalGuiyangChina
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Wu MH, Xiao LF, Yan FF, Chen SL, Zhang C, Lei J, Deng ZM. Use of percutaneous microwave ablation for the treatment of bone tumors: a retrospective study of clinical outcomes in 47 patients. Cancer Imaging 2019; 19:87. [PMID: 31849340 PMCID: PMC6918630 DOI: 10.1186/s40644-019-0275-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/06/2019] [Indexed: 12/27/2022] Open
Abstract
Objective The present study aimed to evaluate the short-term clinical performance and safety of percutaneous microwave ablation (MWA) techniques for the treatment of bone tumors. Methods This single-institution retrospective study investigated 47 cases of bone tumors treated by MWA from June 2015 to June 2018. The study included 26 patients (55.3%) with benign bone tumors and 21 patients (44.7%) with malignant bone tumors. The tumors were located in the spine or sacrum (15, 31.9%), the upper extremities (6, 12.8%), the lower extremities (17, 36.2%) and the pelvis (9, 19.1%). Outcomes regarding clinical efficacy, including pain relief, quality of life, and intervention-related complications, were evaluated before and after MWA using the visual analog scale (VAS) and the 36-item Short-Form Health Survey (SF-36) scoring system. Results Of the 47 patients included in this study, all of them completed follow-up examinations, with a mean follow-up duration of 4.8 ± 1.6 months (range, 2–9 months). Significantly improved VAS and SF-36 scores were recorded after the initial treatment (P<0.001), suggesting that almost 100% of patients experienced pain relief and an improved quality of life following surgery. No major intervention-related complications (e.g., serious neurovascular injury or infection) occurred during or after the treatment. We recorded only three minor posttreatment complications (6.4%, 3/47), which were related to thermal injury that caused myofasciitis and affected wound healing. Conclusion In our study, the short-term efficacy of MWA was considerably favorable, with a relatively low rate of complications. Our results also showed that MWA was effective for pain relief and improved patients’ quality of life, making it a feasible treatment alternative for bone tumors.
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Affiliation(s)
- Min-Hao Wu
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, 168 Donghu Street, Wuchang District, Wuhan, 430071, Hubei, People's Republic of China
| | - Ling-Fei Xiao
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, 168 Donghu Street, Wuchang District, Wuhan, 430071, Hubei, People's Republic of China
| | - Fei-Fei Yan
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, 168 Donghu Street, Wuchang District, Wuhan, 430071, Hubei, People's Republic of China
| | - Shi-Liang Chen
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, 168 Donghu Street, Wuchang District, Wuhan, 430071, Hubei, People's Republic of China
| | - Chong Zhang
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, 168 Donghu Street, Wuchang District, Wuhan, 430071, Hubei, People's Republic of China
| | - Jun Lei
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, 168 Donghu Street, Wuchang District, Wuhan, 430071, Hubei, People's Republic of China
| | - Zhou-Ming Deng
- Department of Spine Surgery and Musculoskeletal Tumor, Zhongnan Hospital of Wuhan University, 168 Donghu Street, Wuchang District, Wuhan, 430071, Hubei, People's Republic of China.
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Anglickis M, Anglickienė G, Andreikaitė G, Skrebūnas A. Microwave Thermal Ablation versus Open Partial Nephrectomy for the Treatment of Small Renal Tumors in Patients Over 70 Years Old. ACTA ACUST UNITED AC 2019; 55:medicina55100664. [PMID: 31581459 PMCID: PMC6843191 DOI: 10.3390/medicina55100664] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/20/2019] [Accepted: 09/27/2019] [Indexed: 11/16/2022]
Abstract
Background and objectives: Microwave thermal ablation (MWT) is one of the treatment options for kidney cancer. However, for patients over 70 years old the safety and oncological efficacy of this treatment is still controversial. The goal of this study was to compare MWT with open partial nephrectomy (OPN) and to find out whether MWT is preferable in maintaining patient renal function and reducing the risk of postoperative complications. Materials and Methods: Depending on the treatment choice, all patients were divided into two groups: an MWT group and an open kidney resection (OPN) group. Data have been retrospectively collected for 7 years, starting with January 2012 up to January 2019. A total number of 33 patients with exophytic, single small renal masses were treated with either OPN (n = 18) or MWT (n = 15). All patients had histologically proven T1 kidney cancer. MWT was performed for patients who refused to have OPN or in those cases where the collecting system, renal calyx, and great vessels were free from tumor margins of more than 1 cm. Results: In the MWT group a median (IQR) patients' age was 75 years (71-79) years, in the OPN group-71.5 (70-75) years, p = 0.005. A median (IQR) Charleston comorbidity index in the MWT group was 7.5 (5-10) and in the same way in the OPN group it was 5.22 (5-6), p = 0.005. A median (IQR) estimated glomerular filtration rate (eGFR) before surgery was higher in the MWT group 59.9 (49.5-73.8) mL/min/1.73 m2 vs. 46.2 (42.7-65.8) mL/min/1.73 m2 in the OPN group, p = 0.12. Three days following the surgery a median (IQR) eGFR was 56.45 (46.6-71.9) in MWT group mL/min/1.73 m2 vs. 43.45 (38.3-65) mL/min/1.73 m2) in the OPN group, p = 0.30. A median (IQR) of primary hemoglobin level was lower in the MWT group compared with the OPN group (134.5 (124-140) g/L vs. 125 (108-138) g/L), p = 0.41. However, after the surgery a median (IQR) lower hemoglobin level was detected in the OPN group (123.5 (111-134) g/L vs. 126 (112-135)), p = 0.53. The median (IQR) duration of the procedure in MWT group was shorter compared with the OPN group (26 (25-30) min vs. 67.5 (55-90) min), p < 0.0001. A median (IQR) hospitalization time was shorter in MWT group (3 (2-3) days vs. 89 (7-11.5) days), p < 0.0001. Pain by the visual analogue scale (VAS) scale the first day after surgery was significantly lower-median (IQR) in the MWT group was 2 (1-3) vs. 4 (3-6)), p = 0.008. Treatment failure rate was numerically higher in MWT (1/15 vs. 0/18, p = 0.56). Conclusions: Pain level on the next day after surgery, mean number of hospitalization and operation time were significantly lower in the MWT group than in the OPN group. The blood loss estimated glomerular filtration rate and oncologic data between the two groups was not statistically significant.
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Affiliation(s)
- Marius Anglickis
- Department of Urology, Vilnius City Clinical Hospital, 10207 Vilnius, Lithuania.
| | - Giedrė Anglickienė
- Department of Chemotherapy, National Cancer Institute, 08406 Vilnius, Lithuania.
| | - Gintarė Andreikaitė
- Department of Urology, Vilnius City Clinical Hospital, 10207 Vilnius, Lithuania.
| | - Arminas Skrebūnas
- Department of Vascular Surgery, Vilnius City Clinical Hospital, 10207 Vilnius, Lithuania.
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Rinzler ES, Shivaram GM, Shaw DW, Monroe EJ, Koo KSH. Microwave ablation of osteoid osteoma: initial experience and efficacy. Pediatr Radiol 2019; 49:566-570. [PMID: 30617514 DOI: 10.1007/s00247-018-4327-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/26/2018] [Accepted: 12/09/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Image-guided percutaneous microwave ablation has been used to treat adult osteoid osteomas but has not been thoroughly evaluated in the pediatric population. OBJECTIVE To evaluate the technical feasibility and clinical efficacy of microwave ablation to treat osteoid osteomas in pediatric patients. MATERIALS AND METHODS The electronic medical record and imaging archive were reviewed for 24 consecutive patients who had undergone microwave ablation of osteoid osteomas between January 1, 2015, and May 31, 2018, at a single tertiary care pediatric hospital. All patients were diagnosed by clinical and imaging criteria, and referred by a pediatric orthopedic surgeon after failing conservative management with pain medication. The average age of the patients was 13.3 years (range: 3-18 years), and the average size of the osteoid osteoma nidus was 8.8 mm (range: 5-22 mm). Technical success was defined as placement of the microwave antenna at the distal margin of the lesion nidus and achievement of the target ablation temperature. Clinical findings were assessed pre- and post-ablation and clinical success was defined as complete relief of pain without pain medication at 1-month follow-up. The number and severity of complications were also documented. RESULTS Clinical success was achieved in 100% of patients (24/24), with all reporting complete cessation of pain medication use 1 week after treatment and 0/10 pain at 1 month. There were 4 minor complications (17%) including access site numbness and a minor soft-tissue infection. There were no major complications. CONCLUSION Microwave ablation is a technically feasible and clinically effective treatment for pediatric osteoid osteomas.
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Affiliation(s)
- Elliot S Rinzler
- Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, M/S MA.7.220, PO Box 5371, Seattle, WA, 98145, USA.
| | - Giridhar M Shivaram
- Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, M/S MA.7.220, PO Box 5371, Seattle, WA, 98145, USA
| | - Dennis W Shaw
- Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, M/S MA.7.220, PO Box 5371, Seattle, WA, 98145, USA
| | - Eric J Monroe
- Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, M/S MA.7.220, PO Box 5371, Seattle, WA, 98145, USA
| | - Kevin S H Koo
- Department of Radiology, Section of Interventional Radiology, Seattle Children's Hospital, M/S MA.7.220, PO Box 5371, Seattle, WA, 98145, USA
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Garnon J, Tricard T, Cazzato RL, Cathelineau X, Gangi A, Lang H. [Percutaneous renal ablation: Pre-, per-, post-interventional evaluation modalities and adapted management]. Prog Urol 2017; 27:971-993. [PMID: 28942001 DOI: 10.1016/j.purol.2017.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 08/20/2017] [Accepted: 08/23/2017] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Ablative treatment (AT) rise is foreseen, validation of steps to insure good proceedings is needed. By looking over the process of the patient, this study evaluates the requirements and choices needed in every step of the management. METHODS We searched MEDLINE®, Embase®, using (MeSH) words and we looked for all the studies. Investigators graded the strength of evidence in terms of methodology, language and relevance. RESULTS Explanations of AT proposal rather than partial nephrectomy or surveillance have to be discussed in a consultation shared by urologist and interventional radiologist. Per-procedure choices depend on predictable ballistic difficulties. High volume, proximity of the hilum or of a risky organ are in favor of general anesthesia, cryotherapy and computed tomography/magnetic resonance imaging (CT/MRI). Percutaneous approach should be privileged, as it seems as effective as the laparoscopic approach. Early and delayed complications have to be treated both by urologist and radiologist. Surveillance by CT/MRI insure of the lack of contrast-enhanced in the treated area. Patients and tumors criteria, in case of incomplete treatment or recurrence, are the key of the appropriate treatment: surgery, second session of AT, surveillance. CONCLUSION AT treatments require patient's comprehension, excellent coordination of the partnership between urologist and radiologist and relevant choices during intervention.
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Affiliation(s)
- J Garnon
- Service d'imagerie interventionnelle, CHU de Strasbourg, 67000 Strasbourg, France
| | - T Tricard
- Service de chirurgie urologique, CHU de Strasbourg, 67000 Strasbourg, France.
| | - R L Cazzato
- Service d'imagerie interventionnelle, CHU de Strasbourg, 67000 Strasbourg, France
| | - X Cathelineau
- Département d'urologie, institut Montsouris, 75014 Paris, France; Université Paris-Descartes, 75006 Paris, France
| | - A Gangi
- Service d'imagerie interventionnelle, CHU de Strasbourg, 67000 Strasbourg, France
| | - H Lang
- Service de chirurgie urologique, CHU de Strasbourg, 67000 Strasbourg, France
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11
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12
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Renz BW, Boeck S, Roeder F, Trumm C, Heinemann V, Werner J. Oligometastatic Disease in Pancreatic Cancer - How to Proceed? Visc Med 2017; 33:36-41. [PMID: 28612015 DOI: 10.1159/000455027] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Pancreatic cancer is a highly aggressive malignancy and will become the second leading cause of cancer-related death in the USA and also in Germany by 2030. Furthermore, the majority of patients with pancreatic ductal adenocarcinoma (PDAC) will present with distant metastases, limiting surgical management in this population as there is little evidence available to support surgical or ablative treatment options for advanced-stage disease. However, highly selected patients suffering from synchronous and metachronous oligometastatic PDAC may potentially benefit from a surgical resection with an acceptable morbidity. METHODS This review summarizes and discusses the current literature on the management of oligometastatic disease regarding PDAC, focusing on para-aortic lymph nodes as well as isolated hepatic and pulmonary metastases. RESULTS AND CONCLUSION In order to further investigate the feasibility and efficacy of such an approach, a prospective multicenter trial, in which survival and quality of life after metastatic resection and systemic chemotherapy is evaluated, has to be initiated. Additionally, local and locoregional ablation techniques or stereotactic body radiation therapy as therapeutic options for isolated metastases in PDAC need further research in order to determine their significance and benefit.
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Affiliation(s)
- Bernhard W Renz
- Department of General, Visceral and Transplantation Surgery, Hospital of the University of Munich, Munich, Germany, Munich, Germany.,Pancreatic Cancer Center Munich, Comprehensive Cancer Center-LMU, University of Munich, Munich, Germany, Munich, Germany
| | - Stefan Boeck
- Pancreatic Cancer Center Munich, Comprehensive Cancer Center-LMU, University of Munich, Munich, Germany, Munich, Germany.,Department of Internal Medicine III, Hospital of the University of Munich, Munich, Germany, Munich, Germany
| | - Falk Roeder
- Pancreatic Cancer Center Munich, Comprehensive Cancer Center-LMU, University of Munich, Munich, Germany, Munich, Germany.,Department of Radiation Oncology, Hospital of the University of Munich, Munich, Germany, Munich, Germany.,Department of Molecular Radiation Oncology, German Cancer Research Center, Heidelberg, Germany, Munich, Germany
| | - Christoph Trumm
- Department of Clinical Radiology, Hospital of the University of Munich, Munich, Germany
| | - Volker Heinemann
- Pancreatic Cancer Center Munich, Comprehensive Cancer Center-LMU, University of Munich, Munich, Germany, Munich, Germany.,Department of Internal Medicine III, Hospital of the University of Munich, Munich, Germany, Munich, Germany
| | - Jens Werner
- Department of General, Visceral and Transplantation Surgery, Hospital of the University of Munich, Munich, Germany, Munich, Germany.,Pancreatic Cancer Center Munich, Comprehensive Cancer Center-LMU, University of Munich, Munich, Germany, Munich, Germany
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13
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Cornelis FH, Marcelin C, Bernhard JC. Microwave ablation of renal tumors: A narrative review of technical considerations and clinical results. Diagn Interv Imaging 2016; 98:287-297. [PMID: 28011104 DOI: 10.1016/j.diii.2016.12.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 12/01/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE The purpose of this review was to identify the specific technical considerations to adequately perform microwave ablations (MWA) of renal tumors and analyze the currently available clinical results. METHODS Using Medline, a systematic review was performed including articles published between January 2000 and September 2016. English language original articles, reviews and editorials were selected based on their clinical relevance. RESULTS MWA has several theoretical advantages over radiofrequency ablation in consistently providing higher intratumoral temperatures. MWA is less dependent of electrical conductivities of tissues and the delivered energy is less limited by desiccation of heated tissues. While there are insufficient data, especially because of a lack of studies with mid- to long-term follow-up, to determine the oncologic effectiveness of MWA, this technique appears safe and effective for the ablation of T1 renal tumors. There is evidence for using mid-level settings based on experimental and clinical data. Power set at 50-65W for 5-15min appears adequate in kidney but close clinical and imaging follow-up have to be performed. CONCLUSION Renal MWA offers theoretical advantages by comparison with other available techniques to treat renal tumors. However, MWA suffers of less cumulative data compared to radiofrequency ablation or cryoablation. Moreover, microwaves still require further studies to identify the optimal tumor characteristics and device settings leading to predictable ablation.
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Affiliation(s)
- F H Cornelis
- Department of radiology, Tenon hospital, 4, rue de la Chine, 75020 Paris, France.
| | - C Marcelin
- Department of radiology, Pellegrin hospital, place Amélie-Raba-Léon, 33076 Bordeaux, France
| | - J-C Bernhard
- Department of urology, Pellegrin hospital, place Amélie-Raba-Léon, 33076 Bordeaux, France
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Iguchi T, Hiraki T, Tomita K, Gobara H, Fujiwara H, Sakurai J, Matsui Y, Kanazawa S. Simultaneous biopsy and radiofrequency ablation of T1a renal cell carcinoma. Diagn Interv Imaging 2016; 97:1159-1164. [DOI: 10.1016/j.diii.2016.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 04/24/2016] [Accepted: 05/02/2016] [Indexed: 12/18/2022]
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15
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Wong J, Cooper A. Local Ablation for Solid Tumor Liver Metastases: Techniques and Treatment Efficacy. Cancer Control 2016; 23:30-5. [PMID: 27009454 DOI: 10.1177/107327481602300106] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Treatment options for liver metastases from solid tumors, such as colon cancer, breast cancer, neuroendocrine tumors, and sarcomas, have expanded in recent years and now include nonresection methods. METHODS The literature focused on the treatment of liver metastases was reviewed for technique, perioperative, and long-term outcomes specifically related to local ablation techniques for liver metastases. RESULTS Ablation modalities have become popular as therapies for patients who are not appropriate candidates for surgical resection. Use of these techniques, alone or in combination with other liver-directed therapies (and often systemic therapy), has extended the rate of survival for patients with liver metastases and, at times, offers nearly equivalent disease-free survival rates to surgical resection. CONCLUSIONS Although surgical resection remains the optimal treatment for liver metastasis, local options, including microwave ablation and radiofrequency ablation, can offer similar long-term local control in appropriately selected patients.
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Affiliation(s)
- Joyce Wong
- Department of Surgical Oncology, Penn State Hershey Medical Center, Hershey, PA 17033, USA.
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16
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Barat M, Fohlen A, Cassinotto C, Jannot AS, Dautry R, Pelage JP, Boudiaf M, Pocard M, Eveno C, Taouli B, Soyer P, Dohan A. One-month apparent diffusion coefficient correlates with response to radiofrequency ablation of hepatocellular carcinoma. J Magn Reson Imaging 2016; 45:1648-1658. [PMID: 27766709 DOI: 10.1002/jmri.25521] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 10/05/2016] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To assess whether apparent diffusion coefficient (ADC) values at 1 and 3 months after radiofrequency ablation (RFA) may be associated with a favorable response to therapy for hepatocellular carcinoma (HCC) and liver metastases. MATERIALS AND METHODS Fifty-nine patients with HCC (n = 35) or liver metastases (n = 24) who underwent 1.5T diffusion-weighted magnetic resonance imaging (DWMRI) at 1 and 3 months post-RFA were included. ADC values of patients with local tumor recurrence were compared to those without local recurrence. A subgroup analysis was performed for HCC and metastases. RESULTS Thirty-eight HCC and 27 metastases were evaluated. The ADC value of HCC at 1 month after RFA was lower in recurrent tumors (0.957 ± 0.229 [SD] × 10-3 mm2 ) compared to tumors with complete response (1.414 ± 0.322 [SD] × 10-3 mm2 /s, P = 0.006). At multivariate analysis, ADC at 1 month was the single independent variable associated with recurrence for HCC (area under the receiver operating characteristic curve = 0.860). No significant association was observed for liver metastases (P = 0.089). CONCLUSION A low ADC value at 1 month after RFA is associated with an early local recurrence of HCC. This study does not confirm that such association exists for hepatic metastases. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1648-1658.
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Affiliation(s)
- Maxime Barat
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Paris, France
| | - Audrey Fohlen
- CNRS, UMR 6301-ISTCT, CERVOxy, GIP CYCERON, Caen, France.,CEA, DSV/I2BM, UMR6301-ISTCT, Caen, France.,Normandie Université, France.,UNICAEN, UMR6301-ISTCT, Caen, France.,CHU de CAEN, Service d'Imagerie Diagnostique et de Radiologie Thérapeutique, Caen, France
| | - Christophe Cassinotto
- Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France.,INSERM U1053, Université Bordeaux, Bordeaux, France
| | - Anne Sophie Jannot
- INSERM-UMRS 1138 Team 22, Cordeliers Research Center, Paris, France.,Paris Descartes University, Paris, France.,Department of Medical Informatics and Public Health, European George Pompidou Hospital, Paris, France
| | - Raphael Dautry
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Paris, France
| | - Jean-Pierre Pelage
- CNRS, UMR 6301-ISTCT, CERVOxy, GIP CYCERON, Caen, France.,CEA, DSV/I2BM, UMR6301-ISTCT, Caen, France.,Normandie Université, France.,UNICAEN, UMR6301-ISTCT, Caen, France.,CHU de CAEN, Service d'Imagerie Diagnostique et de Radiologie Thérapeutique, Caen, France
| | - Mourad Boudiaf
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Paris, France
| | - Marc Pocard
- Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.,UMR CART - INSERM 965, Hôpital Lariboisière, Paris, France.,Department of Digestive Surgery, Hôpital Lariboisière, Paris, France
| | - Clarisse Eveno
- Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.,UMR CART - INSERM 965, Hôpital Lariboisière, Paris, France.,Department of Digestive Surgery, Hôpital Lariboisière, Paris, France
| | - Bachir Taouli
- Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Philippe Soyer
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Paris, France.,Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.,UMR CART - INSERM 965, Hôpital Lariboisière, Paris, France
| | - Anthony Dohan
- Department of Body and Interventional Imaging, Hôpital Lariboisière, Paris, France.,Université Paris-Diderot, Sorbonne-Paris Cité, Paris, France.,UMR CART - INSERM 965, Hôpital Lariboisière, Paris, France.,McGill University Health Center, Department of Radiology, McGill University Health Center, Montreal, QC, Canada
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17
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Zaidi N, Okoh A, Yigitbas H, Yazici P, Ali N, Berber E. Laparoscopic microwave thermosphere ablation of malignant liver tumors: An analysis of 53 cases. J Surg Oncol 2015; 113:130-4. [PMID: 26659827 DOI: 10.1002/jso.24127] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 11/22/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Microwave thermosphere ablation (MTA) is a new technology that is designed to create spherical zones of ablation using a single antenna. The aim of this study is to assess the results of MTA in a large series of patients. METHODS This was a prospective study assessing the use of MTA in patients with malignant liver tumors. The procedures were done mostly laparoscopically and ablation zones created were assessed for completeness of tumor response, spherical geometry and recurrence on tri-phasic CT scans done on follow-up. RESULTS There were a total of 53 patients with an average of 3 tumors measuring 1.5 cm. Ablations were performed laparoscopically in all but eight patients. Morbidity was 11.3% (n = 6), and mortality zero. On postoperative scans, there was 99.3% tumor destruction. Roundness indices A, B, and transverse were 1.1, 1.0, and 0.9, respectively. At a median follow-up of 4.5 months, incomplete ablation was seen in 1 of 149 lesions treated (0.7%) and local tumor recurrence in 1 lesion (0.7%). CONCLUSIONS The results of this series confirm the safety and feasibility of MTA technology. The 99.3% rate of complete tumor ablation and low rate of local recurrence at short-term follow up are promising.
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Affiliation(s)
- Nisar Zaidi
- Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Alexis Okoh
- Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Hakan Yigitbas
- Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Pinar Yazici
- Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Noaman Ali
- Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Eren Berber
- Departments of General and Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio
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Poggi G, Tosoratti N, Montagna B, Picchi C. Microwave ablation of hepatocellular carcinoma. World J Hepatol 2015; 7:2578-2589. [PMID: 26557950 PMCID: PMC4635143 DOI: 10.4254/wjh.v7.i25.2578] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 08/17/2015] [Accepted: 10/19/2015] [Indexed: 02/06/2023] Open
Abstract
Although surgical resection is still the optimal treatment option for early-stage hepatocellular carcinoma (HCC) in patients with well compensated cirrhosis, thermal ablation techniques provide a valid non-surgical treatment alternative, thanks to their minimal invasiveness, excellent tolerability and safety profile, proven efficacy in local disease control, virtually unlimited repeatability and cost-effectiveness. Different energy sources are currently employed in clinics as physical agents for percutaneous or intra-surgical thermal ablation of HCC nodules. Among them, radiofrequency (RF) currents are the most used, while microwave ablations (MWA) are becoming increasingly popular. Starting from the 90s’, RF ablation (RFA) rapidly became the standard of care in ablation, especially in the treatment of small HCC nodules; however, RFA exhibits substantial performance limitations in the treatment of large lesions and/or tumors located near major heat sinks. MWA, first introduced in the Far Eastern clinical practice in the 80s’, showing promising results but also severe limitations in the controllability of the emitted field and in the high amount of power employed for the ablation of large tumors, resulting in a poor coagulative performance and a relatively high complication rate, nowadays shows better results both in terms of treatment controllability and of overall coagulative performance, thanks to the improvement of technology. In this review we provide an extensive and detailed overview of the key physical and technical aspects of MWA and of the currently available systems, and we want to discuss the most relevant published data on MWA treatments of HCC nodules in regard to clinical results and to the type and rate of complications, both in absolute terms and in comparison with RFA.
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19
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Lu F, Poruk KE, Weiss MJ. Surgery for oligometastasis of pancreatic cancer. Chin J Cancer Res 2015; 27:358-67. [PMID: 26361405 DOI: 10.3978/j.issn.1000-9604.2015.05.02] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/08/2015] [Indexed: 12/17/2022] Open
Abstract
The incidence of pancreatic adenocarcinoma (PDAC) has steadily increased over the past several decades. The majority of PDAC patients will present with distant metastases, limiting surgical management in this population. Hepatectomy and pulmonary metastasectomy (PM) has been well established for colorectal cancer patients with isolated, resectable hepatic or pulmonary metastatic disease. Recent advancements in effective systemic therapy for PDAC have led to the selection of certain patients where metastectomy may be potentially indicated. However, the indication for resection of oligometastases in PDAC is not well defined. This review will discuss the current literature on the surgical management of metastatic disease for PDAC with a specific focus on surgical resection for isolated hepatic and pulmonary metastases.
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Affiliation(s)
- Fengchun Lu
- 1 Department of General Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China ; 2 Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Katherine E Poruk
- 1 Department of General Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China ; 2 Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Matthew J Weiss
- 1 Department of General Surgery, Union Hospital, Fujian Medical University, Fuzhou 350001, China ; 2 Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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20
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Iguchi T, Inoue D, Tatsukawa M, Yabushita K, Sakaguchi K, Kanazawa S. Transpulmonary radiofrequency ablation of hepatocellular carcinoma contiguous to the heart. Diagn Interv Imaging 2015; 96:1207-9. [PMID: 26277644 DOI: 10.1016/j.diii.2015.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 06/13/2015] [Accepted: 06/15/2015] [Indexed: 11/16/2022]
Affiliation(s)
- T Iguchi
- Department of Diagnostic and Interventional Radiology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan; Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
| | - D Inoue
- Department of Diagnostic and Interventional Radiology, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - M Tatsukawa
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - K Yabushita
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - K Sakaguchi
- Department of Internal Medicine, Fukuyama City Hospital, 5-23-1 Zao-cho, Fukuyama 721-8511, Japan.
| | - S Kanazawa
- Department of Radiology, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
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Berber E. Laparoscopic microwave thermosphere ablation of malignant liver tumors: an initial clinical evaluation. Surg Endosc 2015; 30:692-698. [DOI: 10.1007/s00464-015-4261-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/19/2015] [Indexed: 12/21/2022]
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22
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Moncharmont L, Moreau-Gaudry A, Medici M, Bricault I. Phantom evaluation of a navigation system for out-of-plane CT-guided puncture. Diagn Interv Imaging 2015; 96:531-6. [DOI: 10.1016/j.diii.2015.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 03/02/2015] [Accepted: 03/23/2015] [Indexed: 12/30/2022]
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