Radiofrequency ablation of colorectal hepatic metastases

581 Background: Radiofrequency ablation (RFA) is a recognized treatment modality in the management of patients with colorectal cancer liver metastasis (CRCLM). Our goal was to assess factors affecting long-term survival of patients undergoing RFA of CRCLM. Methods: We prospectively evaluated patients with unresectable CRCLM that underwent laparoscopic RFA. Patients were assessed pre- and postoperatively using triphasic computed tomography (CT) and intraoperatively using laparoscopic ultrasound. All information was entered into an IRB approved database. Pre-operative predictors were identified using Cox modeling. Postoperative chemotherapy was analyzed for its affect on survival. Results: 312 patients underwent 397 RFA sessions from 1999 to 2010. Patients averaged 2.7 lesions, with a dominant diameter of 3.4 cm and a preoperative CEA of 76. 28% had preoperative extrahepatic disease. Median survival on Kaplan-Meier analysis was 32 months, with 3 and 5 years survivals of 44% and 22%, respectively. The following were statistically significant on univariate and multivariable analysis: number of tumors (hazard ratio (HR) of 1.13 per tumor p=0.0002), dominate tumor diameter (HR 1.14 per cm p=0.03), pre-operative CEA (HR of 1.002 per one point rise p<.0001), and pre-operative extrahepatic disease (HR 1.4 p=0.05). Post-operative chemotherapy was shown to improve survival after controlling for the presence of new disease in follow-up. Conclusions: To our knowledge, this is both the largest and longest follow-up of RFA for unresectable CRCLM. The number and size of tumors, and preoperative CEA value are strong predictors of survival whereas pre-operative extrahepatic disease had mild impact on survival. Post-operative chemotherapy was shown to improve survival after controlling for other factors.

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Radiofrequency Ablation for Resectable Colorectal Hepatic Metastases

Annals of Surgery ◽

10.1097/sla.0b013e3181dbb1f8 ◽

2010 ◽

Vol 251 (5) ◽

pp. 804-806 ◽

Cited By ~ 8

Author(s):

M. B. Majella Doyle ◽

William C. Chapman

Keyword(s):

Radiofrequency Ablation ◽

Hepatic Metastases ◽

Colorectal Hepatic Metastases

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Long-Term Results of Percutaneous Radiofrequency Ablation of Unresectable Colorectal Hepatic Metastases: Final Outcomes

Digestive Surgery ◽

10.1159/000107717 ◽

2007 ◽

Vol 24 (5) ◽

pp. 358-360 ◽

Cited By ~ 15

Author(s):

A. Suppiah ◽

T.J. White ◽

S.H. Roy-Choudhury ◽

D.J. Breen ◽

J. Cast ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Hepatic Metastases ◽

Long Term Results ◽

Percutaneous Radiofrequency Ablation ◽

Colorectal Hepatic Metastases

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The Detectability of Hepatic Metastases in Candidates of Radiofrequency Ablation: Comparison for Helical CT Scanning and Late-Phase Pulse-Inversion Harmonic Imaging

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2002.46.2.149 ◽

2002 ◽

Vol 46 (2) ◽

pp. 149

Author(s):

Kang Won Lee ◽

Kwon Ha Yoon ◽

Eun A Kim ◽

Ki Han Park ◽

Seon Kwan Juhng ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Late Phase ◽

Hepatic Metastases ◽

Helical Ct ◽

Ct Scanning ◽

Harmonic Imaging ◽

Pulse Inversion ◽

Pulse Inversion Harmonic Imaging

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Long-Term Survival of Two Patients with Liver Metastases from Advanced Gastric Cancer Treated with Radiofrequency Ablation and Chemotherapy

Case Reports in Oncology ◽

10.1159/000507849 ◽

2021 ◽

pp. 67-72

Author(s):

Sung Jin Oh

Keyword(s):

Gastric Cancer ◽

Radiofrequency Ablation ◽

Liver Metastases ◽

Advanced Gastric Cancer ◽

Systemic Chemotherapy ◽

Subtotal Gastrectomy ◽

Hepatic Metastases ◽

Term Survival ◽

Long Term Survival

Liver metastasis from gastric cancer has a very poor prognosis. Herein, we present two cases of liver metastases (synchronous and metachronous) from advanced gastric cancer. In the first case, the patient underwent radical subtotal gastrectomy. Liver metastases occurred 6 months after surgery while the patient was receiving adjuvant chemotherapy, but two hepatic tumors were successfully removed by radiofrequency ablation (RFA). In the second case, liver metastases occurred 15 months after surgery for gastric cancer. The patient also received RFA for one hepatic tumor, and other suspicious metastatic tumors were treated with systemic chemotherapy. Although these case presentations are limited for the efficacy of RFA treatment with systemic chemotherapy for hepatic metastases from gastric cancer, our findings showed long-term survival (overall survival for 108 and 67 months, respectively) of the affected patients, without recurrence. Therefore, we suggest that RFA treatment with systemic chemotherapy could be an effective alternative treatment modality for hepatic metastases from gastric cancer.

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