In most current guidelines concerning liver tumors (and other entities) "unresectable" patients are graduated "palliative" despite the availability of new minimal invasive options (RFA, SRFA, MWA,..) that have the potential for local curation. There is no doubt that with percutaneous thermal ablation small tumors can be completely eradicated. Using sophisticated guidance technologies (Stereotactic Radiofrequency Ablation - SRFA) even large tumors can be ablated completely by multiple probe positioning, with local recurrence rates comparable to resection.
Many patients, that are categorized "unresectable" can be treated locally by thermal ablation and should therefore remain in the "curative" setting. In my opinion all guidelines concerning the liver ( and maybe other tumor entities) should be re-written, with replacement of " resectable" by "treatable with local curative intent" / "treatable with local curation".
You mean primary (hepatocellular carcinoma) or secondary (metastatic) liver cancer?
I think that the two words are not interchangeable, since "resectable" refers to a primary or metastatic lesion that can be fully removed by surgical means, whereas "treatable with local curative intent" possesses a broader sense that is to say that other approaches, such as RFA, RT or even SRS, can provide local control on their own or supplementally to local surgical intervention.
"Resectable" is a historical technical term. It derives from times where the only local curative treatment option for liver lesions was resection. For oncology it is not important if it is resectable. The only information that is key is whether local curative treatment is feasible ( independent of the method...). The question whether local curation is possible depends on the individual patient situation and the technique/intervenionalist/surgeon that is available.
This is applicable for primary and secondary liver lesions..
Treatment modalities for malignancy are:
Local Which includes the obvious+potential continous/contigous area of spread. The extent will depend on the type of malignancy as well as the type of treatment.
Regional/locoregional: Which classically includes regional lymph nodes, there again extent depend on tumour type
Systemic.
Resection is a type of local treatment, used with reference to Surgery; may be wide excision, lumpectomy, etc., etc.,There can be other types of treatment for locan control including radiotheray, hyperthermia, RFA, etc. This may be curative or non-curative which indicates the aim of treatment rather than the result.
Narayanan
Resection is a surgical procedure,but curative for cancer is related to a definitive DNA marked.
Dear Reman,resection in Oncology is a anatomical procedure but not curative(opinion of a surgeon with 45 years of experience in head and neck oncology)
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