Interventional Methods for Treating Liver and Lung Metastases

What treatment methods are used for liver and lung metastases, and when are they prescribed?

Prof. Dr. med. Paprottka: The choice of method depends on the patient's condition, liver/lung function, and other comorbidities. We use two primary approaches:

·       Local methods, such as thermal ablation or microwave ablation, which directly destroy the tumor at its site.

·       Locoregional methods are used when there are more metastases or larger ones. These methods help control tumor growth, although they may not always completely eliminate it.

Are there any contraindications for these methods?

Prof. Dr. med. Paprottka: Contraindications may include uncorrectable blood clotting disorders or when metastases are located too close to other organs, such as the intestines. For methods that affect a larger portion of the liver, contraindications could include a heavy tumor burden or pre-existing liver failure.

What complications may arise, and what are the chances of success?

Prof. Dr. med. Paprottka: Complications, such as bleeding, are rare and can be managed, for instance, with a catheter. Depending on the size of the metastases, localized infections may occur but can be effectively treated with antibiotics. Regular follow-up exams with CT or MRI scans are essential a few weeks post-procedures to confirm the complete destruction of tumor cells.

Are there clinical studies on these methods?

Prof. Dr. med. Paprottka: Research in this area is ongoing, and the data are constantly updated. It is essential to note that some criteria for the use of interventional methods are adapted from experience in treating metastases of other cancer types, such as colorectal. Methods like radiofrequency ablation (RFA) and microwave ablation (MWA) have proven effective for treating small, inoperable metastases. For example, they have shown good results when the number of metastases does not exceed five and their size is up to 3 cm.

Additionally, intravascular methods, such as transarterial chemoembolization (TACE) and selective internal radiation therapy (SIRT), play an important role in a comprehensive approach to treating metastases. These methods are especially effective in cases of chemoresistant liver metastases, where the primary goal is improving quality of life and controlling symptoms. Combining these technologies allows for individualized treatment plans for each patient, based on the latest advancements in medicine.

The full interview can be read in Mamazone