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Forum Name: Lung Cancer

Question: RFA or Cyberknife


 Karhart - Fri Nov 04, 2005 3:44 pm

Thank you for your reply to my earlier post. My husbands last CT scan showed slight growth in one of the liver tumors. More troubling is suggested possible new small ones. We do not know how many he has, but they have been measuring 2 and remarking on multiple others.

My ? is could having a procedure such as RFA or cyberknife on the larger tumors extend his life? He does not have any symptoms from the liver tumors. His small lung nodules are stabe. I realize that getting rid of the bigger tumors will not help with the other smaller ones. It does seem that it would at least slow down the progression in his liver. Right now I am just trying to but time. How much of your liver can be compromised and still be able to function? Thank you so much for your very informative site.
 Dr. A. De la Guerra - Tue Nov 08, 2005 7:40 pm

User avatar Karen,

Unfortunately, based on current scientific evidence, I cannot tell you if reducing the tumor’s burden will slow down the progression in his liver. There have not been many reports of liver metastasectomy after treatment for lung cancer. Reports published before 1988 did not consider that resection of metastases was worthwhile. More recent reports have been more favorable and this reflects the improvements in liver surgery that have since taken place.

There are guidelines as to which patients can have surgery for liver metastases. In general patients should have 5 or less separate metastatic sites to the liver. These need to be localized in one area such that they can be removed. A functional portion of the liver will need to remain, approximately 2/3rds of the liver can be resected and due to the liver's regenerative capacity a patient with a normal liver prior to surgery can do quite well.

Surgery for metastatic disease to the liver is not indicated when there are multiple tumors or extrahepatic disease is present, because to achieve control of disease progression we need to get rid of all the tumors. Chemotherapy is the best treatment option in those cases, or if disease is stable and there are no symptoms, maybe just follow-up and take care of the problems as they appear.

I wish the best for you and your husband.

Sincerely, Dr_Torax.

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