26
|
Paprottka PM, Walter A, Haug A, Trumm C, Jakobs TF, Reiser MF, Zech C. Sicherheit der Radioembolisation mit 90Yttrium-Mikrosphären in Abhängigkeit vom prä-interventionellen Verschluss aberranter Gefäße. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
27
|
Muacevic A, Füerweger C, Trumm C, Nuhn P, Staehler M. CyberKnife Robotic Radiosurgery of Three Pancreatic Metastases of Renal Cell Cancer in One Treatment Session. Cureus 2014. [DOI: 10.7759/cureus.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
28
|
Ashoori N, Paprottka P, Trumm C, Bamberg F, Kolligs FT, Rentsch M, Reiser MF, Jakobs TF. Multimodality treatment with conventional transcatheter arterial chemoembolization and radiofrequency ablation for unresectable hepatocellular carcinoma. Digestion 2012; 85:18-26. [PMID: 22156507 DOI: 10.1159/000334714] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 10/21/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS To evaluate the efficacy of multimodality treatment consisting of conventional transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) in patients with non-resectable and non-ablatable hepatocellular carcinoma (HCC). METHODS In this retrospective study, 85 consecutive patients with HCC (59 solitary, 29 multifocal HCC) received TACE followed by RFA between 2001 and 2010. The mean number of tumors per patient was 1.6 ± 0.7 with a mean size of 3.0 ± 0.9 cm. Both local efficacy and patient survival were evaluated. RESULTS Of 120 treated HCCs, 99 (82.5%) showed a complete response (CR), while in 21 HCCs (17.5%) a partial response was depicted. Patients with solitary HCC revealed CR in 91% (51/56); in patients with multifocal HCC (n = 29) CR was achieved in 75% (48 of 64 HCCs). The median survival for all patients was 25.5 months. The 1-, 2-, 3- and 5-year survival rates were 84.6, 58.7, 37.6 and 14.6%, respectively. Statistical analysis revealed a significant difference in survival between Barcelona Clinic Liver Cancer (BCLC) A (73.4 months) and B (50.3 months) patients, while analyses failed to show a difference for Child-Pugh score, Cancer of Liver Italian Program (CLIP) score and tumor distribution pattern. CONCLUSION TACE combined with RFA provides an effective treatment approach with high local tumor control rates and promising survival data, especially for BCLC A patients. Randomized trials are needed to compare this multimodality approach with a single modality approach for early-stage HCC.
Collapse
|
29
|
Clevert DA, Helck A, Paprottka PM, Zengel P, Trumm C, Reiser MF. [Ultrasound-guided image fusion with computed tomography and magnetic resonance imaging. Clinical utility for imaging and interventional diagnostics of hepatic lesions]. Radiologe 2012; 52:63-9. [PMID: 22249703 DOI: 10.1007/s00117-011-2252-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Abdominal ultrasound is often the first-line imaging modality for assessing focal liver lesions. Due to various new ultrasound techniques, such as image fusion, global positioning system (GPS) tracking and needle tracking guided biopsy, abdominal ultrasound now has great potential regarding detection, characterization and treatment of focal liver lesions. Furthermore, these new techniques will help to improve the clinical management of patients before and during interventional procedures. This article presents the principle and clinical impact of recently developed techniques in the field of ultrasound, e.g. image fusion, GPS tracking and needle tracking guided biopsy and discusses the results based on a feasibility study on 20 patients with focal hepatic lesions.
Collapse
|
30
|
Haug AR, Tiega Donfack BP, Trumm C, Zech CJ, Michl M, Laubender RP, Uebleis C, Bartenstein P, Heinemann V, Hacker M. 18F-FDG PET/CT predicts survival after radioembolization of hepatic metastases from breast cancer. J Nucl Med 2012; 53:371-7. [PMID: 22331219 DOI: 10.2967/jnumed.111.096230] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
UNLABELLED (90)Y radioembolization (selective internal radiation therapy [SIRT]) has emerged as a valuable therapeutic option in unresectable, chemotherapy-refractory hepatic metastases from breast cancer. The objective of the present study was to evaluate (18)F-FDG PET/CT for predicting survival in these patients. METHODS Fifty-eight consecutive patients with hepatic metastases from breast cancer were treated with SIRT. Before therapy, all patients underwent MRI of the liver. (18)F-FDG PET/CT was performed at baseline and 3 mo after SIRT to calculate percentage changes in maximum (18)F-FDG standardized uptake value (SUV(max)) relative to baseline. A decrease of more than 30% in the follow-up scan, compared with the baseline examination, indicated therapy response. Treatment response at 3 mo was also assessed in 43 patients using contrast-enhanced MRI and CT on the basis of the Response Evaluation Criteria in Solid Tumors. All patients were followed to complete survival data. RESULTS Overall median survival after SIRT was 47 wk. Response as assessed with SUV(max) correlated significantly with survival after radioembolization, with responders having significantly longer survival (65 wk) than nonresponders (43 wk; P < 0.05). In multivariate analysis the change in SUV(max) was identified as the only independent predictor of survival (hazard ratio, 0.23; P < 0.005). Furthermore, a high pretherapeutic SUV(max) (>20) was associated with a significantly shorter median survival than was an SUV(max) of 20 or less (21 vs. 52 wk; P < 0.005). The presence of extrahepatic metastases (mean survival in both groups, 47 wk; P = 0.92), hormone receptor status (estrogen, P = 0.53; progesterone, P = 0.79; Her-2/neu, P = 0.49), and MRI/CT response (P = 0.91) did not predict survival. CONCLUSION The change in SUV(max) as assessed by (18)F-FDG PET/CT before and 3 mo after SIRT was identified as the only independent predictor of survival in patients with hepatic metastases of breast cancer.
Collapse
|
31
|
Paprottka P, Haug A, Zech C, Sommer W, Bartenstein P, Reiser M, Trumm C. Radioembolisation von nicht-resektablen neuroendokrinen Lebermetastasen. ACTA ACUST UNITED AC 2011. [DOI: 10.1055/s-0031-1295435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
32
|
Clevert DA, Helck A, D’Anastasi M, Trumm C, Meimarakis G, Weidenhagen R, Kopp R, Jauch K, Reiser M. Ultraschallgesteuerte EVAR-Interventionen und Follow-up-Diagnostik mit der kontrastmittelgestützten Sonographie und der Bildfusion. GEFASSCHIRURGIE 2011. [DOI: 10.1007/s00772-011-0892-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
33
|
Trumm C, Jakobs T, Pahl A, Stahl R, Helmberger T, Paprottka P, Reiser M, Hoffmann RT. CT fluoroscopy-guided percutaneous vertebroplasty in patients with multiple myeloma: analysis of technical results from 44 sessions with 67 vertebrae treated. Diagn Interv Radiol 2011; 18:111-20. [PMID: 22006576 DOI: 10.4261/1305-3825.dir.4226-11.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
PURPOSE This study aimed to assess the results of computed tomography (CT) fluoroscopy-guided vertebroplasty in patients with multiple myeloma, focusing on the frequency and clinical impact of polymethylmethacrylate (PMMA) leaks. MATERIALS AND METHODS From December 2001 to August 2008, 39 patients (17 females, 22 males; mean age, 65±7 years) with multiple myeloma suffering from painful spinal osteolyses underwent vertebroplasty. A total of 67 vertebrae were treated in 44 sessions under CT fluoroscopy (single-slice, 4-row CT, and 16-row CT). In the planning CT scan, osteolytic destruction (i.e., none, ≤25%, ≤50%, ≤75%, or ≤100%) was assessed regarding the vertebral cross-sectional area, the cortical border of the spinal canal, and the outer circumference. CT performed after vertebroplasty was used to detect local PMMA leaks. Patient charts were retrospectively reviewed with special respect to peri and postinterventional adverse events. Clinical outcomes were assessed on a visual analog scale (VAS) 24 hours before, 24 hours after, and 6 months after vertebroplasty. RESULTS Overall, 37.3%, 12.0%, and 6.0% of vertebrae showed at least 50% osteolytic involvement of the cross-sectional area, spinal canal, and outer vertebral cortex, respectively. Intradiscal, intraspinal, paravertebral, and intercostovertebral/posterolateral leaks were seen in 21.6%, 35.1%, 43.3%, and 0% of vertebrae, respectively. The ratio of basivertebral to segmental venous leaks was 16.2%/40.5%. No major complications occurred. The mean VAS score decreased significantly (P < 0.05) from 6.4 at 24 hours before vertebroplasty to 3.2 at a mean follow-up of 9.0 months. CONCLUSION Vertebroplasty in multiple myeloma can be performed safely under CT fluoroscopy, even with substantial destruction of the vertebral cross-sectional area or cortical bone. A high clinical success rate was achieved, regardless of whether PMMA leaks were present.
Collapse
|
34
|
Herold T, Seiler T, Egensperger R, Trumm C, Bergmann M, Franke D, Mumm FFH, Schinwald N, Buske C, Dreyling M. Progressive multifocal leukoencephalopathy after treatment with rituximab, fludarabine and cyclophosphamide in a patient with chronic lymphocytic leukemia. Leuk Lymphoma 2011; 53:169-72. [DOI: 10.3109/10428194.2011.608446] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
35
|
Paprottka P, Jakobs TF, Bamberg TF, Trumm C, Reiser MF, Hoffmann RT. Yttrium-90 Radioembolisation bei Patienten mit unresezierbaren cholangiozellulären Karzinomen. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
36
|
Paprottka PM, Hoffmann RT, Trumm C, Schmidt GP, Reiser M, Jakobs T. 90Yttrium-Microsphären-Radioembolisation von symtomatischen, unresizierbaren neuroendokrinen Lebermetastasen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
37
|
Paprottka PM, Räßler F, Hoffmann RT, Trumm C, Schmidt GP, Reiser M, Jakobs T. Hepatische Yttrium-90 Radioembolisation von chemotherapierefraktären Metastasen bei kolorektalem Karzinom. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
38
|
Schmidt D, Bieberstein J, Schumann C, Trumm C, Bruners P, Weihusen A, Clasen S, Claussen C, Pereira PL. Evaluierung eines computerunterstützten Verfahren zur schnellen automatischen Ablationssondenplatzierung für die minimal-invasive CT gesteuerte RFA maligner Leberneoplasien. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
39
|
Hoffmann RT, Jakobs TF, Kubisch CH, Trumm C, Weber C, Siebels M, Helmberger TK, Reiser MF. Renal cell carcinoma in patients with a solitary kidney after nephrectomy treated with radiofrequency ablation: Mid term results. Eur J Radiol 2010; 73:652-6. [PMID: 19181470 DOI: 10.1016/j.ejrad.2008.12.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Revised: 12/12/2008] [Accepted: 12/23/2008] [Indexed: 01/29/2023]
|
40
|
Trumm C, Hoffmann RT, Reiser MF. [Radiological interventional procedures for the acute abdomen]. Radiologe 2010; 50:262-71. [PMID: 20182685 DOI: 10.1007/s00117-009-1905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
In patients with acute thrombo-embolic occlusion of the superior mesenteric artery, catheter-assisted thrombolytic therapy represents a procedure of increasing importance in addition to surgery and intensive care treatment. The thrombolytic drugs utilized for this purpose are urokinase, streptokinase and recombinant tissue plasminogen activator (rtPA).Therapeutic embolization is predominantly used in the treatment of arterial bleeding from the gastro-intestinal tract, the liver, the intestines (due to an aneurysm or vascular malformation) and in bleeding from intestinal anastomoses. Polyvinyl alcohol particles, embospheres, gelfoam and microcoils can be utilized as embolic agents. Percutaneous transhepatic cholangiodrainage and stent implantation are applied in patients with biliary obstructions caused by inoperable tumors of the gall bladder or bile ducts, of the pancreatic head or duodenum and by metastases located in the liver parenchyma or hepatic hilum.Image-guided percutaneous drainage is a valuable option in the management of abscesses in the peritoneal cavity; less common indications are lymphoceles, biliomas, urinomas, hematomas, necrosis and pseudocysts.
Collapse
|
41
|
Kolligs FT, Hoffmann RT, op den Winkel M, Bruns CJ, Herrmann K, Jakobs TF, Lamerz R, Trumm C, Zech CJ, Wilkowski R, Graeb C. [Diagnosis and multimodal therapy for hepatocellular carcinoma]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2010; 48:274-88. [PMID: 20119895 DOI: 10.1055/s-0028-1109901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death in the world. The majority of HCCs develops on the basis of a chronic liver disease. This often complicates diagnosis and therapy. Non-invasive diagnostic criteria are based on dynamic imaging techniques and the serum level of AFP (alpha-fetoprotein). When evaluating HCC patients for therapy, besides tumor burden and localisation, the therapeutic evaluation must also consider the general condition of the patient and his/her liver function. For this purpose, the BCLC algorithm of the Barcelona Clinic for Liver Disease has proven helpful. Only one-third of the patients can be cured by resection, transplantation or local tumour ablation. In locally advanced cases transarterial procedures including transarterial chemoembolisation and radioembolisation are applied. HCC is a chemo-resistant tumour and chemotherapy is not accepted as standard of care in HCC. Sorafenib is the first systemic treatment with proven efficacy approved for the treatment of advanced and metastatic HCC. Interdisciplinary management of HCC patients is essential in order to provide every patient with the optimal therapy at his specific stage of disease.
Collapse
|
42
|
Trumm C, Jakobs T, Zech CJ, Reiser MF, Hoffmann RT. CT-gesteuerte Vertebroplastie von spinalen Osteolysen bei Patienten mit multiplem Myelom: Technische Ergebnisse bei 67 behandelten Wirbelkörpern. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
43
|
Hoffmann RT, Jakobs TF, Kubisch CH, Stemmler HJ, Trumm C, Tatsch K, Helmberger TK, Reiser MF. Radiofrequency ablation after selective internal radiation therapy with Yttrium90 microspheres in metastatic liver disease-Is it feasible? Eur J Radiol 2009; 74:199-205. [PMID: 19269763 DOI: 10.1016/j.ejrad.2009.02.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2008] [Revised: 02/05/2009] [Accepted: 02/05/2009] [Indexed: 01/04/2023]
Abstract
This retrospective study analyzes, whether patients suffering from extensive hepatic metastatic disease treated with SIRT can become suitable candidates for RFA.Within 38 months 46 patients (26 female, 20 male; age 32-75 years) bearing an extensive hepatic metastatic disease were treated with SIRT. Patients suffered from metastases of breast cancer (16/46), colorectal cancer (CRC) (21/46), neuroendocrine (3/46), and other primary carcinomas (6/46). The indication for SIRT was otherwise untreatable metastases confined to the liver. Forty-three patients received single-session whole-liver radioembolization treatment using Yttrium90 resin microspheres with a mean activity of 2.13GBq. In 1 patient SIRT was confined to the left and in 2 patients to the right liver lobe. In 3 patients major complications (2/3 gastric ulceration and 1/3 oedematous pancreatitis) and in 24 patients minor complications occurred (acute abdominal/epigastric pain and/or nausea). Follow-up CT and/or MRI were obtained in 44 of 46 patients. In 5 of 44 patients tumor load decreased substantially (3/5 breast cancer, 1/5 CRC and 1/5 pancreatic cancer) making RFA feasible. The patients were referred for RFA after the first 3-month follow-up. RFA of the liver was successful in all cases in terms of complete ablation. In selected patients radioembolization is able to downstage liver metastases to an extent making a subsequent RFA suitable and therefore allows increasing the number of patients with a "complete response" after a minimally invasive therapy.
Collapse
|
44
|
Jakobs TF, Hoffmann RT, Tatsch K, Trumm C, Reiser MF. [Therapy response of liver tumors after selective internal radiation therapy]. Radiologe 2009; 48:839-49. [PMID: 18766324 DOI: 10.1007/s00117-008-1730-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Selective internal radiation therapy (SIRT) is used for the treatment of patients with liver tumors, especially for those with hepatocellular carcinoma (HCC) or liver metastases from various primary tumors. Currently this innovative treatment concept is recommended when established state-of-the-art treatment regimes have failed and tumor progression is noted or if the treatment has to be abandoned because of intolerable toxic effects. For SIRT small biocompatible microspheres (SIR-Spheres(R)) are labelled with the radioactive isotope 90Yttrium, a pure beta emitter, and are superselectively infused into the hepatic arteries. The microspheres are collected in the precapillary vessels in and surrounding the tumor. The beta radiation of 90Yttrium has an average penetration in tissue of approximately 2.5 mm and results in very high doses of radiation being selectively targeted to metastases providing protection to the surrounding healthy liver tissue. In this paper we review the results of SIRT in patients with hepatic metastases from colorectal cancer, breast cancer, neuroendocrine tumors and primary liver cancer (HCC).
Collapse
|
45
|
Jakobs TF, Hoffmann RT, Dehm K, Trumm C, Stemmler HJ, Tatsch K, La Fougere C, Murthy R, Helmberger TK, Reiser MF. Hepatic yttrium-90 radioembolization of chemotherapy-refractory colorectal cancer liver metastases. J Vasc Interv Radiol 2008; 19:1187-95. [PMID: 18656012 DOI: 10.1016/j.jvir.2008.05.013] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2007] [Revised: 04/28/2008] [Accepted: 05/16/2008] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To present data for radioembolization with yttrium-90 ((90)Y) resin microspheres in patients with colorectal cancer liver metastases in whom currently available therapies had failed. MATERIALS AND METHODS Retrospective review was conducted of case files of patients with colorectal cancer liver metastases in whom chemotherapy had failed, prompting hepatic (90)Y radioembolization administered as a single-session, whole-liver treatment. Imaging and laboratory follow-up results were available for 36 patients. Response and toxicity were assessed by computed tomography/magnetic resonance imaging with the Response Evaluation Criteria in Solid Tumors and the National Cancer Institute's Common Terminology Criteria for Adverse Events, version 3.0. RESULTS Forty-one patients (mean age, 61 years; 30 men) received hepatic (90)Y radioembolization with resin microspheres (mean activity, 1.9 GBq). At a median interval of 2.9 months after radioembolization, partial response, stable disease, and progressive disease were demonstrated in seven, 25, and four patients, respectively. Median overall survival was 10.5 months, with improved survival for patients with a decrease in carcinoembryonic antigen level (19.1 months vs 5.4 months) and imaging response (29.3 months vs 4.3 months; P = .0001). Except for one instance of treatment-associated cholecystitis (grade 4 toxicity) and two gastric ulcers (grade 2 toxicity), no severe toxicities were observed. CONCLUSIONS Hepatic (90)Y radioembolization can be performed with manageable toxicity in patients with colorectal cancer liver metastases whose disease is refractory to chemotherapy. The antitumoral effect is supported by imaging and tumor marker responses. Further investigation is warranted to determine the optimal use of this emerging therapeutic modality.
Collapse
|
46
|
Jakobs TF, Hoffmann RT, Schrader A, Stemmler HJ, Trumm C, Lubienski A, Murthy R, Helmberger TK, Reiser MF. CT-guided radiofrequency ablation in patients with hepatic metastases from breast cancer. Cardiovasc Intervent Radiol 2008; 32:38-46. [PMID: 18575933 DOI: 10.1007/s00270-008-9384-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 05/27/2008] [Accepted: 06/03/2008] [Indexed: 01/14/2023]
Abstract
The purpose of this study was to evaluate technical success, technique effectiveness, and survival following radiofrequency ablation for breast cancer liver metastases and to determine prognostic factors. Forty-three patients with 111 breast cancer liver metastases underwent CT-guided percutaneous radiofrequency (RF) ablation. Technical success and technique effectiveness was evaluated by performing serial CT scans. We assessed the prognostic value of hormone receptor status, overexpression of human epidermal growth factor receptor 2 (HER2), and presence of extrahepatic tumor spread. Survival rates were calculated using the Kaplan-Meier method. Technical success was achieved in 107 metastases (96%). Primary technique effectiveness was 96%. During follow-up local tumor progression was observed in 15 metastases, representing a secondary technique effectiveness of 86.5%. The overall time to progression to the liver was 10.5 months. The estimated overall median survival was 58.6 months. There was no significant difference in terms of survival probability with respect to hormone receptor status, HER2 overexpression, and presence of isolated bone metastases. Survival was significantly lower among patients with extrahepatic disease, with the exception of skeletal metastases. We conclude that CT-guided RF ablation of liver metastases from breast cancer can be performed with a high degree of technical success and technique effectiveness, providing promising survival rates in patients with no visceral extrahepatic disease. Solitary bone metastases did not negatively affect survival probability after RF ablation.
Collapse
|
47
|
Jakobs T, Hoffmann RT, Dehm K, Trumm C, Stemmler HJ, Tatsch K, Murthy R, Helmberger T, Reiser M. Abstract No. 30: Regional 90Yttrium Microsphere Treatment of Chemotherapy-Refractory Colorectal Cancer Liver Metastases. J Vasc Interv Radiol 2008. [DOI: 10.1016/j.jvir.2007.12.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
48
|
Notohamiprodjo M, Horng A, Horger W, Park J, Trumm C, Raya JG, Reiser M, Glaser C. Hochaufgelöste Knie-MRT bei 3 Tesla mit einer 3D- moderat T2-gewichteten TSE-Sequenz (SPACE). ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
49
|
Trumm C, Matzko M, Grosse C, Helck A, Ertl-Wagner B, Reiser M. Einfluss eines modifizierten Outlook Web Access (OWA)-Systems auf die Verfügbarkeit teleradiologischer Notfallbefunde. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
50
|
Jakobs TF, Hoffmann RT, Dehm K, Trumm C, Stemmler HJ, Tatsch K, Helmberger T, Reiser M. Regionale 90Yttrium Radioembolisation beim hepatisch metastasierten kolorektalen Karzinom. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|