The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Radiofrequency ablation for the treatment of colorectal liver metastases.
It replaces the previous guidance on Radiofrequency ablation for the treatment of colorectal metastases in the liver (NICE interventional procedures guidance 92, September 2004).
Colorectal cancer is a type of cancer that develops in the bowel (including the colon and rectum). In some patients, cancer cells could spread from the bowel to other parts of the body to form one or more ‘secondary tumours’, also known as ‘metastases’. For bowel cancer, most commonly secondary tumours occur in the liver.
Radiofrequency ablation uses heat to destroy cancer cells in the liver. It involves placing one or more electrodes into the tumour. The electrodes are used to heat the tumour with the aim of destroying it. Radiofrequency ablation can be applied through the skin or during surgery.
J12.4 Percutaneous radiofrequency ablation of lesion of liver
Y53.- Approach to organ under image control
Note: Codes within category Y53.- are used as secondary codes to classify interventions that are percutaneous and require some form of image control: 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 and a code from category C18.- Malignant neoplasm of colon would be recorded.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account, and specifically any special arrangements relating to the introduction of new interventional procedures. The guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.