Laser thermal ablation in multimodality treatment of liver metastases from neuroendocrine tumors

17-20 October 2014 Paris, France 62th Annual Meeting JFR Journées Françaises de Radiologie http://jfr.radiologie.fr/ Liver metastases (LM) from neuroendocrine tumors (NET) occur with variable frequency depending on the primary disease, ranging from 5-10% for carcinoid to 75% for glucagonoma1. LM have a major impact on survival, and the relatively indolent nature of well-differentiated NET and their proclivity to be hormonally active warrant aggressive treatment even for advanced stage disease. Systemic medical therapy is marginally effective in NET, and aggressive cytoreduction using combined multimodality treatments such as surgery, transarterial chemoembolization, and thermal ablation, can improve both survival and quality of life. The reported 5-year survival of patients with LM from NET treated medically ranges from 0 to 30%. In contrast, aggressive cytoreduction has been reported to achieve 5-year survival rates ranging from 48 to 83%1,2, and many guidelines for the management of NET recommend the removal of at least 90% of LM whenever possible2, 3,4. To this aim, surgical resection is considered the gold standard, but only 10-20% of patients with NET are actually candidates for resection because the disease is too extensive. Moreover, the 5and 10-year recurrence rates after resection are 84% and 94%, respectively, with a median time to recurrence of 21 months1. Consequently, the need of frequently retreating the patients makes less invasive methods of aggressive cytoreduction a quite interesting option. Image-guided thermal ablation offers the possibility of a minimally invasive technique that is usually associated with less morbidity than Laser thermal ablation in multimodality treatment of liver metastases from neuroendocrine tumors