Radiofrequency Ablation of Colorectal Liver Metastases: Small Size Favorably Predicts Technique Effectiveness and Survival

• Published in: Cardiovascular and interventional radiology 2008-09, Vol.31 (5), p.948-956
• Main Authors: Veltri, Andrea, Sacchetto, Paola, Tosetti, Irene, Pagano, Eva, Fava, Cesare, Gandini, Giovanni
• Format: Article
• Language: English
• Subjects: ABLATION; Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Analysis of Variance; BODY; Cardiology; Catheter Ablation - methods; Chi-Square Distribution; Clinical Investigation; Cohort Studies; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - therapy; DIGESTIVE SYSTEM; ELECTROMAGNETIC RADIATION; Female; Follow-Up Studies; GLANDS; Humans; Imaging; Kaplan-Meier Estimate; LIVER; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; MEDICINE; Medicine & Public Health; METASTASES; Middle Aged; Minimally Invasive Surgical Procedures - methods; Multivariate Analysis; Neoplasm Staging; Nuclear Medicine; ORGANS; Predictive Value of Tests; Quality of Life; RADIATIONS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOWAVE RADIATION; Retrospective Studies; Risk Assessment; SURGERY; Survival Analysis; SURVIVAL TIME; Treatment Outcome; Ultrasound
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-008-9362-0

The objective of this study was to analyze long-term results of radiofrequency thermal ablation (RFA) for colorectal metastases (MTS), in order to evaluate predictors for adverse events, technique effectiveness, and survival. One hundred ninety-nine nonresectable MTS (0.5–8 cm; mean, 2.9 cm) in 122 patients underwent a total of 166 RFA sessions, percutaneously or during surgery. The technique was “simple” or “combined” with vascular occlusion. The mean follow-up time was 24.2 months. Complications, technique effectiveness, and survival rates were statistically analyzed. Adverse events occurred in 8.1% of lesions (major complication rate: 1.1%), 7.1% with simple and 16.7% with combined technique ( p  = 0.15). Early complete response was obtained in 151 lesions (81.2%), but 49 lesions (26.3%) recurred locally after a mean of 10.4 months. Sustained complete ablation was achieved in 66.7% of lesions ≤3 cm versus 33.3% of lesions >3 cm ( p  3 cm ( p  = 0.006). We conclude that “simple” RFA is safe and successful for MTS ≤3 cm, contributing to prolong survival when patients can be completely treated.