Colorectal Cancer Hepatic Metastases Can Be Treated with Radiofrequency Ablation

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(ChemotherapyAdvisor) – Radiofrequency ablation can be used to treat colorectal cancer liver metastases and salvage surgical recurrence, with a median overall survival of 40 months, investigators reported during the Society of Interventional Radiology's 37th Annual Scientific Meeting in San Francisco, CA, on March 25.

Okoro et al. from New York University and Memorial Sloan-Kettering Cancer Center, New York, NY, identified 126 patients (70 male) with a mean age of 61.4 years from a prospectively created, HIPPA-compliant database who had undergone 159 computed tomography (CT)-guided radiofrequency ablations between December 2002 and March 2011 for 175 total primary and recurrent lesions.

Medical records and relevant imaging were reviewed to determine technical success (ablation protocol completed and tumor covered on immediate postablation CT), complete ablation (no enhancing tumor within four to six weeks following radiofrequency ablation contrast CT), complications and local tumor progression at the site of ablation, local tumor progression-free survival, and overall survival.

Tumor size ranged from 0.5 to 7cm; 86 patients had at least one prior hepatectomy (surgical group) and 40 patients had no prior hepatectomy (nonsurgical group). “Technical success was achieved in all 159 ablation sessions,” the investigators noted. Complete ablation was documented in 169 of 175 lesions. Failures resulted from poor visualization and inadequate tumor targeting (n=4), large tumor size (n=1) or tumor proximity to a blood vessel (n=1).

Overall survival was 92.5% at one year, 51.1% at two years, and 33.1% at five years. Median survival from initial diagnosis of colorectal cancer liver metastases to death was 75.4 months. Median overall primary local tumor progression-free survival was 16.1 months; rates were 58.2% at one year, 33.2% at two years, and 27.9% at five years. No statistically significant difference was observed in median overall survival and median primary local tumor progression-free survival between the surgical and nonsurgical groups.

Complications included pneumothorax, perihepatic hematoma, pleural effusion, liver abscess, and intrahepatic hematoma.

Abstract

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