Husband's 2nd liver recurrence

I don't have a lot 0f info

I don't have a lot 0f info for you but I just wanted to say I am so sorry that you are faced with reoccurence. I know there are many people that have a second liver resection (and some that have stayed NED for many years after) which gives me hope. I pray that it is operable and ultimately cured. GOD bless you.

Brenda

Liver biopsy

Given your husband's history, I wonder why they would do a biopsy?  If the PET shows uptake and he's already had mets there.....

I just want to warn you that with liver biopsies, there is a possibility of dropping cells into the abdomen which is why so many oncologists won't recommond that anymore.   An ultra sound can help to confirm mets because it will show depth and density.   I'm guessing but maybe the spot that is now 4.7x2.2 cm was a little seedling that showed some uptake but was too small to measure?  Sometimes the PET can show uptake but it turns out to be some sort of inflammation and is gone on the next scan.

As for liver resections, I've heard of up to 3 but that was one person only.  I know several people who have had 2 resections.   Before my lung mets appeared, the plan for me was a 2 stage resection.  Most of right lobe out on the first go.  Heal for 3 months and take the left lobe out.  It's not and unusual procedure anymore.  Keep an eye on that lung nodule! 

 

I have had three liver
I have had three liver resections over the course of 7 years.

Yes, I'm sure another
Yes, I'm sure another resection is possible. Sorry you're having to deal with all this again. My husband had a recurrence in his liver recently. Numerous lesions distributed from one end to the other. We're trying to find a liver specialist that can help. Good luck to you and your husband.

Chelsea

alexinlv said:

Thank you,

Wow! A lot of info to take in and a lot of work ahead to figure this out! But we've done it before and can do it again. I knew you guys would give more help than the 20 min  visit with oncologist last Thursday. .  i'm not wasting any time with the dr here.   Tony had  his resection at ucla with a fabulous team! I'm going to email them right away. ill let you know,their  answers.  Xo. Ps- when I mentioned to my husband yesterday that surgery is better than rfa he cringed at the thought of going through it again.   

haha yes cringe

ahhhh I understand his reaction of cringing....it is not a fun operation ....actually I think my second resection was less intense than the first.  For one thing they had to take less tissue but I think you know what to expect second time round.  My surgeon used the same incision site to reduce scars but he also warned that the rate of infection is slightly higher on number 2 because the scar tissue does not not mend as well.  I had no trouble with infection.  

My last resection was in 2008 and I did a full course of oxalyplatin and xeloda afterwards.....indeed i have been NED since then.....

 

I wish you both all the very very best....stay in touch and let us know how you are doing....

 

maggie

jasminsaba said:

RFA vs. Resection

My understanding, based on research and consultations with specialists, is that while liver resection remains the current gold standard for treatment of hepatic mets, it is certainly not the ONLY curative avenue to pursue.

There is shortage of long-term data on RFA because it's a rather recent procedure though what data is available is very promising and indicates good response and long-term remissions ... and even cure. It's far less invasive than a liver resection which is why it's likely more attractive to patients. So resection remains the gold standard in the absense of more extensive data for RFA ... once more data becomes available, current practice might shift a bit as well.

Also, in light of recent advancements in chemotherapy for mCRC, there is even a possibility of cure/long-term remission for those with limited metastatic disease. Combination chemo regimens are especially effective on hepatic metastases.

I wish you and your husband all the best with whatever you decide to do ... though there is risk of tumor seeding with a biopsy, many oncologists still recommend the procedure to confirm metastases prior to subjecting their patients to invasive procedures/surgery. That's usually in an early diagnosis setting or for patients with no history of metastatic diasese. In your husband's case, it's very likely that what appears on the CT/PET is indeed another lesion so I agree with others that it's likely not necessary to do a biopsy prior to resection.

Thinking about you guys ... sorry you have to go through this again ... and wishing you all the very best.

"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

Sundanceh said:

Surgery is not absolutely better, Alex...

I had RFA done on the liver over 5-years ago...the studies said "Equal To - if not Better" than resection.

I could be the LONE person on the board, who was RFA'd on the liver...not resected....and is a long time survivor...8.7 years now.

-Craig

RFA

HI, Craig. Where did you have your RFA done, if I might ask?  

 

thanks

Karin

Sundanceh said:

Hi Karin:)

It was done at Baylor Medical Center in Dallas, Texas. 

Surgeon was Dr. Robert Goldstein. He specializes in liver and does transplants...even did Mickey Mantle's liver transplant.

 

liver guy

thanks - appreciate the info. 

 

take good care

 

Karin

Good luck to you and your husband, Alex...

lots of good info here so I have nothing to add, except to say that it took me five major surgeries to get to NED (for now).  It wasn't fun, and I have the ugliest abdominal scar ever, but I don't wear bikinis anymore anyway, so oh well...I'll take being alive over looking pretty.  Your husband can do this, and get to NED too!  Hugs and strength to you both~AA