Microwave ablation for the treatment of liver metastases

NICE interventional procedure guidance [IPG406] Published date:

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The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Microwave ablation for the treatment of liver metastases.

This document replaces previous guidance on Microwave ablation for the treatment of metastases in the liver (interventional procedure guidance IP220).

  • Description

    Liver metastases are a common manifestation of many primary cancers but the liver is usually the dominant site for metastases originating from colorectal or other gastrointestinal tract cancers.  

    The number, location and size of the metastases are the key determinants of treatment intent as well as of treatment choice. For a minority of patients, surgical resection with curative intent may be possible. For most patients, however, treatment intent is palliative. Options for palliative treatment include systemic chemotherapy, external beam radiotherapy, thermal ablation techniques (such as radiofrequency or cryotherapy), arterial embolisation techniques, and selective internal radiation therapy. Multiple treatment modalities may be used for individual patients.

    Thermal ablation techniques are usually used in patients not considered suitable for surgery or for treating post-resection recurrence. They may also be used as an adjunct to hepatic resection to ablate small-volume disease in the remnant post-resection liver.

  • OPCS4.6 Code(s)

    Open procedure:

    J03.2 Destruction of lesion of liver NEC

    Y13.7 Microwave destruction of lesion of organ NOC

     

    Percutaneous procedure:

    J12.7 Percutaneous microwave ablation of lesion of liver

     

    Laparoscopic procedure:

    J08.3 Endoscopic microwave ablation of lesion of liver using laparoscope

    Note: A code from category Y53.- Approach to organ under image control may also be assigned to these procedures if image control has been used. Codes in category Y53.- are used as secondary codes. If the method of image control is unspecified, Y53.9 Unspecified approach to organ under image control is assigned.

    In addition the ICD-10 code C78.7 Secondary malignant neoplasm of liver and intrahepatic bile duct is assigned.

    The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding

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