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RFA or REsection for recurrent liver met ?

sdp's picture
sdp
Posts: 171
Joined: Jan 2012

Hi,

posted this on colon club yesterday but did not get any response. I hope I do get some suggestion or someone can care to enlighten me and put things into perspective.

 After my surgery for the liver and colon mCRC last September I was NED till now and suddenly the cancer markers shot up this month from 3 to 15 (CEA)  And 9 to 16 (CA19.9)

The CT - PET scan shows a single liver met in a new area then before ( Segment 4b). It is 2.5 cm x 2.6 cm with a SUV uptake of 9 plus.  What should be my option of further treatment - RFA or another resection ?

The resection would be difficult to handle as I would again have a long recovery. Some of the opinions I have taken from the docs strongly advise resection as opposed to RFA . However, the research papers which support resection over RFA for a single met < 3 cm that i could access were of 2002. I believe there has been significant progress in RFA techniques since and may be I should opt for RFA over resection.

I seek guidance and suggestion from fellow members about what approach would suffice. Please if anyone of you has been in this situation I would appreciate some guidance. Also, what is the time frame I am looking at to getting this met out of me .?

Thanks in anticipation

Sdp

 

Chelsea71
Posts: 1170
Joined: Sep 2012

I've done extensive reading on this subject and I vote resection ASAP.  I can only imagine how you must dread another surgery and the recovery etc...  But I think it's the best way to go.  I think most surgeons would advise against RFA when a resection is possible.

herdizziness's picture
herdizziness
Posts: 3492
Joined: Apr 2010

and eventually hoping for a third, I rather have the resection then the RFA, WOULD TAKE THE RFA only if a resection (due to 2nd liver resection in May and 2nd colon resection last week) was not offered as a possibility by the surgeon.

Winter Marie

johnnybegood's picture
johnnybegood
Posts: 1122
Joined: Oct 2008

MY experiance and what happend to me in the end it is up to you and your surgen.in september of 2011 i had liver resection.as far as all the numbers i dont recall them at the moment.after healing from the resection i went on irritatecan+avastin.then in feburary of 2012 my scan showed one spot that had come back on my liver.within 2 weeks i was in the hospital getting rfa on my liver spot.i know i will be on chemo for life due to my mets on lungs but as of now my liver has been good since my rfa.lots of luck to you....Godbless...johnnybegood

tanstaafl's picture
tanstaafl
Posts: 1014
Joined: Oct 2010

Personally I think resection and immunochemotherapies, like cimetidine-PSK-D3 and more, would be a more aggressive physical removal approach, less likely to need heavy chemo.  JBG's experience shows a long term success on the liver with RFA and chemo, even in the face of other mets. One question to the surgeons might be whether this RFA limits future resectability or imaging.      

sdp's picture
sdp
Posts: 171
Joined: Jan 2012

Finally got the liver met treated with a new procedure called IRE instead of RFa

as per pet-ct the mesize was 2.5 x2.6 cm - as per ultrasound and MRI it was 3.2 x3.0

as per the docs when they actually went in to do the IRE It was closer to 4 cm 

the entire procedure took over 4 hours and the post procedure MRI shows that they got the entire met 

follow up MRI is after one month 

 

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