Husband's 2nd liver recurrence

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  • herdizziness
    herdizziness Member Posts: 3,624 Member
    alexinlv said:

    Liver resection with lung nodules

    Does anyone have experience with having a second liver resection while having 2 small nodules in lungs? Onc said it is unlikely the liver surgeon would operate. Thank you for you input! 

    Alex

    I had two spots in lungs and had liver resection, now I have about six in lungs and they are still willing to do resection when liver tumors shrink.  That plan on radiation after the liver resection For my lungs.

    Winter Marie

  • PatchAdams
    PatchAdams Member Posts: 271
    Sundanceh said:

    "Not the Only" - You're Right, Jas

    Because I think I'm the ONLY liver person who just had the RFA done and not a liver resection....along with a fatty liver with stage 1 fibrosis to boot.

    The studies I read (waiting room literature) stated:

    "RFA success is Equal To - If not Better" than a liver resection...long considered the gold standard of treatment.

    I'm living proof (8.7 years) that RFA is a bonafide procedure...Equal To...and perhaps better.

    I've not recurred in the liver (docs/surgeon said I would)...and many others have recurred in liver WITH resection.

    No definitive answer either way.

    Mine was invasive, because they prepped me for a resection...until they opened and saw my liver...surgeon told my wife I would die on the O/R table...and that he was moving to RFA...the rest is history.

    Mine was also a BIG tumor.....about 6cm X 8cm....size of an orange.

    They say RFA is better and more effective for much smaller tumors, but I showed how it can be effective for very large tumors as well.

    And while, we could not burn all of the tumor out, due to its location....he got the majority of it....and we finished up locally with 3x Cyberknife treatments.

    It was...and is...considered a success story. 

    -Craig

    MD Anderson disagrees with you Sundanceh

     

    Solitary Colorectal Liver Metastasis Resection Determines Outcome FREE

     

    Thomas A. Aloia, MD; Jean-Nicolas Vauthey, MD; Evelyne M. Loyer, MD; Dario Ribero, MD; Timothy M. Pawlik, MD, MPH; Steven H. Wei, MS, PA-C; Steven A. Curley, MD; Daria Zorzi, MD; Eddie K. Abdalla, MD, Researchers at M.D. Anderson Cancer Center at the University of Texas

     For HR as compared with RFA, the 5-year RFS rates (40% vs 0%, respectively; P = .006) and DFS rates (50% vs 0%, respectively; P = .001) were significantly higher. In addition, 3- and 5-year OS rates were higher after HR (79% and 71%, respectively) compared with RFA (57% and 27%, respectively) (P<.001).

    Present study shows an 80% 3-year survival rate (and a 71% 5-year survival rate) after HR and well-established data showing 10- and 20-year survivors after HR of solitary and multiple metastases, even without adjuvant chemotherapy

     In contrast, survival was significantly shorter in patients treated with RFA. Local tumor recurrence appeared to be the major explanation for inferior survival after RFA (37% of patients found to have LR at a median follow-up interval of 31 months), which was reflected in the markedly reduced DFS rate in patients treated with RFA (0% at 5 years). Whereas the 5-year OS rate after HR was 71%, it was only 27% after RFA. This outcome after RFA is only marginally better than the carefully documented natural history of untreated solitary CLM in patients without extrahepatic disease reported by Wagner et al26 more than 20 years ago.

  • Maxiecat
    Maxiecat Member Posts: 544 Member

    Alex

    I had two spots in lungs and had liver resection, now I have about six in lungs and they are still willing to do resection when liver tumors shrink.  That plan on radiation after the liver resection For my lungs.

    Winter Marie

    Thank you everyone for this

    Thank you everyone for this discussion.   I have a liver MRI scheduled for tis Friday... To check out a liver lesion that was found in my ct scan from dec...don't know why the dr waited almost a month to order it.   Anyway I have been researching options if this issomething that has to come out.  I am signet ring...so I definitely don't want a biopsy....worried about abdominal seeding?  I have been looking into rfa.  

    Alex

  • PatchAdams
    PatchAdams Member Posts: 271
    Maxiecat said:

    Thank you everyone for this

    Thank you everyone for this discussion.   I have a liver MRI scheduled for tis Friday... To check out a liver lesion that was found in my ct scan from dec...don't know why the dr waited almost a month to order it.   Anyway I have been researching options if this issomething that has to come out.  I am signet ring...so I definitely don't want a biopsy....worried about abdominal seeding?  I have been looking into rfa.  

    Alex

    Alex

    Arch Surg -- Abstract: Solitary Colorectal Liver Metastasis: Resection Determines Outcome, May 2006, Aloia et al. 141 (5): 460

     

    Please read the article on RFA vs resection.  Resection has been shown to be much, much better than RFA.

  • tko683
    tko683 Member Posts: 264 Member
    So sorry

    Hi Alex, I am so sorry to hear your news.  It is so confusing to me also.  
    I agree with not needing another liver biopsy.  I would not do that.  We are dealing with similar situation.  New lesions popping up or ones that were there before but too small to see....who knows.  Our surgeon took my husband off chemo for a few months to see what would happen after his clear scan in November and his cea started going way up so they put him back on chemo.  I think you are smart to go to UCLA, you were happy with them and they will most likely be much more helpful.  I am confused as to why they are not doing chemo right now though....sending you wishes for some answers to your questions so that you can move forward....Hugs, Teri

  • Sundanceh
    Sundanceh Member Posts: 4,392 Member

    Alex

    Arch Surg -- Abstract: Solitary Colorectal Liver Metastasis: Resection Determines Outcome, May 2006, Aloia et al. 141 (5): 460

     

    Please read the article on RFA vs resection.  Resection has been shown to be much, much better than RFA.

    But, It Isn't the End All - Be All

    Alex:

    I couldn't qualify for a liver resection...so we had to do RFA...tumor was huge 6cm by 8cm...size of an orange....that's alot of tumor to burn out with RFA, but we had no choice.

    Most of the tumor was burned out, but they could not get all of it due to location....so we Cyberknife'd 3x and eradicated the tumor at a local level...it was considered a success.

    So, while resection will always be the ultimate goal...they wanted to take 80% of my liver....RFA as a procedure...and using myself as a test case, have shown that RFA is an effective procedure.

    The surgeon I did it with told me that resection is the gold standard, but that RFA was moving up...and that the odds were equal to...if not better than a resection.

    I haven't had cancer recur in the liver again.  I was "Guaranteed" that it would return within one year....and that it would be unlikely if I saw the following Xmas.

    That was 5-years ago this past holiday season...

    This is a real-life statistic talking to you...not an abstract article...

    I believe in RFA...because RFA extended my life...and while I recurred anyway...I can't tell you how many folks around here did liver resections and recurred again...and even again. 

     

     

     

  • BusterBrown
    BusterBrown Member Posts: 221 Member
     
    Just 6 months after my

     

    Just 6 months after my first surgery (colon resection), a tumor reappeared on my liver. My doctor decided to use the RFA procedure, which consisteted of a large incision on my belly and the needle in to my liver.  The surgeon was happy with the margins and the way the surgery turned out.  I went approximately 2.5 years without any problems. After one of my many CT scans my Onc noticed that a tumor was back in roughly the same spot where the RFA procedure had occcured.  This time around, my surgeon decided to resect, taking 60% of my liver.  That was rougly 2009, and my liver has been clean ever since, granted I took chemo on and off till Oct. 2011. 

    Good luck with whatever it is you decide.

    Buster