Cryosurgical Ablation of Primary or Metastatic Liver Tumors
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چکیده
Background/Overview Hepatic tumors can be due to primary liver cancer or metastases to the liver from nonhepatic primary tumors. Primary liver cancer can arise from hepatocellular tissue (hepatocellular carcinoma [HCC]) or intrahepatic biliary ducts (cholangiocarcinoma). Multiple tumors metastasize to the liver, but there is particular interest in the treatment of hepatic metastases from colorectal carcinoma (CRC) given the propensity of CRC to metastasize to the liver and the high prevalence of CRC. Liver metastases from neuroendocrine tumors present a unique clinical situation. Neuroendocrine cells produce and secrete a variety of regulatory hormones, or neuropeptides, which include neurotransmitters and growth factors. Overproduction of the specific neuropeptides by cancerous cells causes various symptoms, depending on the hormone produced. Treatment of liver metastases is undertaken to reduce endocrine-related symptoms, in addition to prolonging survival and reducing symptoms related to the hepatic mass.
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Cryosurgical Ablation of Primary or Metastatic Liver Tumors
When Policy Topic is covered Cryosurgical ablation of primary liver tumors may be considered medically necessary for patients who meet ALL of the following criteria: have unresectable primary hepatocellular carcinoma; no detectable extrahepatic metastasis; 5 or fewer lesions present; no single lesion is more than 5cm in diameter; intra-operative ultrasound monitoring and localization ...
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