Secondary Malignant Neoplasm of Liver Clinical Trial
Official title:
Computertomography-guided Wire Marking of Colorectal Hepatic Metastases After Complete Response to Neoadjuvant Chemotherapy. A Pilot Study
The aim of the study is to evaluate if it is possible to mark with a wire colorectal hepatic metastases after complete response to a neoadjuvant chemotherapy.Primary the investigators want to investigate if the wire marking is a possibility to mark respectively to identify these lesions. Further the investigators want to evaluate how many patients with complete radiologic have complete histologic response in their specimen respectively in how many specimens in the definitive histology tumor cells are visible.
Colorectal Cancer is most common in western countries. In 2007 in Austria 4462 new
colorectal cancers were diagnosed. The most common place of metastasis is the liver.
Approximately 15% of patients have metastasis at time of diagnosis of primary tumor and
further 50% will develop metastases in the further course of the disease.However only 10-25%
of patients are candidates for liver resection. New chemotherapeutics, new targeted
therapies with monoclonal antibodies and better surgical techniques improved response rates,
resection rates and overall survival. Owing to improved response rates metastases in the
liver partially respectively completely disappeared, so that these lesions are not more
visible in apparative diagnostic like CT-scan and MRI.
The question is now what to do with this patients? In the literature there is no evidence
how to manage these patients. Conservative management would lead to a reoccurrence of
metastases in the liver. On the other side surgical management is difficult, because
metastases are preoperatively and intraoperatively not visible and resection is only
possible with the removement of greater amounts of healthy tissue.
The computer tomography-guided wire marking of the metastases in the liver is a possibility
to overcome these problems. All patients with complete radiologic response of metastases in
the liver and metastases ≤ 1 cm are included in the study (RECISTE-Criteria). On day of
surgical procedure patients will brought to interventional radiologist and based on computer
tomography images before neoadjuvant chemotherapy the lesions will be marked computer
tomography-guided with a wire(X-Reidy Breast Lesion Localization Needle, Cook Medical). The
wire is placed percutaneously and under antibiotic prophylaxis. After the marking procedure,
the patient is brought into the operating room to resect the metastases in the liver.
;
Observational Model: Cohort, Time Perspective: Prospective
Status | Clinical Trial | Phase | |
---|---|---|---|
Not yet recruiting |
NCT02758977 -
Associating Liver Partition With Portal Vein Ligation for Staged Hepatectomy (ALPPS) vs. Two-Stage Hepatectomy (TSH) for Marginally Resectable Colorectal Liver Metastases (CRLM)
|
N/A | |
Terminated |
NCT02820194 -
A Trial on SBRT Versus MWA for Inoperable Colorectal Liver Metastases (CLM)
|
N/A | |
Completed |
NCT02843802 -
Combination of Cryosurgery and NK Immunotherapy for Advanced Liver Cancer
|
Phase 1/Phase 2 | |
Not yet recruiting |
NCT02647047 -
Spinal Versus Epidural Analgesia in Laparotomic Liver Surgery
|
N/A | |
Active, not recruiting |
NCT01516710 -
Oslo Randomized Laparoscopic Versus Open Liver Resection for Colorectal Metastases Study
|
N/A | |
Completed |
NCT02391207 -
Hepatic Vein-sparing Hepatectomy for Colorectal Liver Metastases at the Caval Confluence
|
N/A | |
Recruiting |
NCT03889093 -
Radioembolization of Primary and Secondary Liver Malignancies and The Effect On The Immune System
|
N/A | |
Completed |
NCT01423734 -
The Reproducibility Of Diffusion Weighted Magnetic Resonance Imaging For Neuroendocrine Tumor Liver Metastases
|
||
Recruiting |
NCT02886104 -
Comparison of Hepatectomy and Local Ablation for Resectable Synchronous and Metachronous Colorectal Liver Metastasis
|
N/A | |
Completed |
NCT00199173 -
Comparing Hepatic Intra-arterial Injection of Yttrium-90 Microspheres Versus Fluorouracil (5FU) in Colorectal Cancer Metastatic to the Liver Only
|
Phase 3 |