Local surgical, ablative, and radiation treatment of metastases Journal Article


Authors: Timmerman, R. D.; Bizekis, C. S.; Pass, H. I.; Fong, Y.; Dupuy, D. E.; Dawson, L. A.; Lu, D.
Article Title: Local surgical, ablative, and radiation treatment of metastases
Abstract: Because local therapies directed toward a specific tumor mass are known to be effective for treating early-stage cancers, it should be no surprise that there has been considerable historical experience using local therapies for metastatic disease. In more recent years, increasing interest in the use of local therapy for metastases likely has arisen from improvements in systemic therapy. In the absence of effective systemic therapies, such local treatments were often considered futile given both the difficulty in eliminating all sites of identifiable metastatic disease as well as realities regarding the rapid natural history of uncontrolled tumor dissemination. However, with a higher likelihood of patients surviving longer after effective systemic therapy, even if not cured, the goal of the eradication of residual metastases via potent local therapies can be rationalized. However, this rationalization should be evidence-based so as to avoid harming patients for no established benefit. Although surgical metastectomy remains the most common and first-line standard among local therapies, nonsurgical alternatives, including thermal ablation and stereotactic body radiotherapy, have become increasingly popular because they are generally less invasive than surgery and have demonstrated considerable promise in eradicating macroscopic tumor. Rather than eliminating the need for local therapies, improvements in systemic therapies appear to be increasing the prudent utilization of modern local therapies in patients presenting with more advanced cancer. ©2009 American Cancer Society, Inc.
Keywords: osteosarcoma; treatment outcome; cancer surgery; surgical technique; survival rate; review; cancer recurrence; liver neoplasms; cancer radiotherapy; positron emission tomography; preoperative evaluation; cytoreductive surgery; melanoma; computer assisted tomography; breast cancer; bleeding; thoracotomy; lung neoplasms; pneumonectomy; radiation injury; kidney carcinoma; colorectal carcinoma; pneumonia; lung embolism; colorectal neoplasms; liver failure; liver metastasis; lung metastasis; heart infarction; radiosurgery; bile leakage; micrometastasis; soft tissue sarcoma; liver resection; surgical mortality; liver disease; hepatectomy; pleura effusion; bile duct fistula; radiofrequency ablation; stereotactic body radiation therapy; germ cell tumor; cost benefit analysis; catheter ablation; videoendoscopy
Journal Title: CA - A Cancer Journal for Clinicians
Volume: 59
Issue: 3
ISSN: 0007-9235
Publisher: Wiley-Blackwell  
Date Published: 2009-05-01
Start Page: 145
End Page: 170
Language: English
DOI: 10.3322/caac.20013
PUBMED: 19364702
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 12" - "Export Date: 30 November 2010" - "CODEN: CAMCA" - "Source: Scopus"
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  1. Yuman Fong
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