Minimally Invasive Treatment of Oligometastasis in the Liver in Recurrent Nasopharyngeal Carcinoma

Jimmy Yu-Wai Chan

Abstract


Objective: The principle of management of patients with oligometastasis is evolving. The current study aims to investigate the efficacy of percutaneous radiofrequency ablation (RFA) of the solitary liver metastasis after previous radiotherapy for nasopharyngeal carcinoma (NPC).
Methods: A pilot study involving 4 patients with biopsy proven solitary liver metastasis from NPC. After creation of artificial ascites, cooltip RFA needle was inserted into the intra-hepatic tumour under ultrasound guidance. Procedure related complications were noted and patients were followed up regularly and indefinitely for oncological outcome.
Results: All patients had locoregionally advanced NPC at initial diagnosis and were treated with concurrent chemoradiation. Complete response was achieved in all patients. The mean time to tumour recurrence was 21.3 months. The mean size of the liver tumour was 3.5cm. Two patients had synchronous local tumour recurrence, and they underwent nasopharyngectomy and neck dissection before receiving treatment to the liver. Percutaneous RFA was performed in all patients. The mean hospital stay was 2.2 days and no procedure related complications were detected. No systemic treatment was given afterwards. The mean follow-up interval was 40.5 months. One of the patients developed progression of disease and died at 13 months after RFA, while the rest of the patients were alive and remained disease free at the last follow-up.
Conclusion: Percutaneous RFA is potentially useful as a minimally invasive procedure for patients with solitary liver metastasis after radiotherapy for NPC. Further study is required to confirm its efficacy and to define the protocol of adjuvant systemic chemotherapy to improve the treatment outcome.

Keywords


Nasopharyngeal carcinoma; oligometastasis; liver; recurrent;

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References


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DOI: http://dx.doi.org/10.15383/jnpc.30

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