Radiofrequency ablation for colorectal liver metastases: prognostic factors in non-surgical candidates

Purpose To determine prognostic factors in patients with colorectal liver metastases who were not surgical candidates and received liver radiofrequency (RF) ablation. Materials and methods RF ablation was done for 141 colorectal liver metastases in 84 patients. There were 63 (75.0 %, 63/84) males an...

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Bibliographic Details
Published in:Japanese journal of radiology 2012-08, Vol.30 (7), p.567-574
Main Authors: Hamada, Ayumi, Yamakado, Koichiro, Nakatsuka, Atsuhiro, Uraki, Junji, Kashima, Masataka, Takaki, Haruyuki, Yamanaka, Takashi, Inoue, Yasuhiro, Kusunoki, Masato, Takeda, Kan
Format: Article
Language:English
Subjects:
Adult
Aged
Catheter Ablation
Colorectal Neoplasms - pathology
Disease Progression
Female
Humans
Imaging
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Nuclear Medicine
Original Article
Prognosis
Proportional Hazards Models
Radiology
Radiotherapy
Retrospective Studies
Survival Rate
Treatment Outcome
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Summary:Purpose To determine prognostic factors in patients with colorectal liver metastases who were not surgical candidates and received liver radiofrequency (RF) ablation. Materials and methods RF ablation was done for 141 colorectal liver metastases in 84 patients. There were 63 (75.0 %, 63/84) males and 21 (25.0 %, 21/84) females, with a mean age of 64.6 ± 10.3. The mean maximum tumor diameter was 2.3 ± 1.4 cm (range 0.5–9.0 cm). Extrahepatic metastases were associated at the time of liver RF ablation in 23 patients (27.4 %, 23/84), and 12 (14.3 %, 12/84) had lung metastases considered controllable by planned lung RF ablation. Prognostic factors were evaluated by univariate and multivariate analyses. Results There was no procedure-related mortality. The 1-, 3-, and 5-year overall survival rates were 90.6 % (95 %CI, 83.9–97.2 %), 44.9 % (95 %CI, 31.8–57.9 %), and 20.8 % (95 %CI, 7.3–34.3 %), respectively, with a median survival of 34.9 months. The univariate analysis showed that tumor diameter larger than 3 cm, tumor multiplicity, uncontrollable extrahepatic disease, and previous chemotherapy history were significantly worse prognostic factors. The former three factors remained significant for worse prognosis in the multivariate Cox model. Extrahepatic disease was not a prognostic factor when it could be controlled. Conclusion Tumor size and number, and uncontrollable extrahepatic metastases were significant prognostic factors.
ISSN:1867-1071
1867-108X
DOI:10.1007/s11604-012-0089-0