Endocrinology & Metabolism Institute Outcomes
Liver
Laparoscopic Liver Tumor Ablation
Laparoscopic liver tumor ablation is appropriate for patients with unresectable disease, who are otherwise unfit for resection, who have a preference for ablation over resection, or those who have small deep tumors which would require a major resection. Prior to September 2014 radiofrequency ablation was used at the Cleveland Clinic and afterward the technique was switched to microwave thermosphere ablation.
Laparoscopic Ablation of Neuroendocrine Liver Metastases
1996–2019
| N | Percent | |
|---|---|---|
| Patients | 130 | |
| Age, median, years (range) | 58 (47-67) | |
| NELM | 782 | |
| Ablation sessions | 180 | |
| Patients with 1 session | 93 | 72% |
| Patients with 2 sessions | 27 | 22% |
| Patients with 3 or more sessions | 10 | 8% |
| Ablation as primary treatment | 101 | 78% |
| Ablation after or concurrent with resection | 29 | 22% |
NELM = neuroendocrine liver metastases
Survival Post-ablation
| N | Percent | Median survival (months) | |
|---|---|---|---|
| Sex | |||
| Male | 71 | 55% | 126 |
| Female | 59 | 45% | 113 |
| Primary pathology | |||
| Carcinoid tumor | 92 | 71% | 125 |
| Pancreatic tumor | 29 | 22% | 118 |
| Medullary thyroid cancer | 9 | 7% | N/A |
| Number of metastases | |||
| Fewer than 5 | 53 | 125 | |
| 5 -10 | 48 | 102 | |
| More than 10 | 22 | 125 | |
| Largest tumor size | |||
| Smaller than 3 cm | 31 | 143 | |
| 3 - 5 cm | 47 | 98 | |
| Larger than 5 cm | 24 | 73 | |
| Extrahepatic disease | |||
| Present | 33 | 25% | 69 |
| Absent | 97 | 75% | 134 |
At median followup of 73 months, overall survival at 5 years was 76%, and 59% at 10 years. Progression free survival was 26% at 5 years and 6% at 10 years.
