Magnetic resonance imaging--guided abdominal interventional radiology: laser-induced thermotherapy of liver metastases.
The aim of this study was to evaluate the clinical benefit of magnetic resonance imaging--guided laser-induced thermotherapy (LITT) for the minimally invasive treatment of liver metastases, with regard to survival rates and local tumor control. Magnetic resonance--guided LITT under local anesthesia was carried out in 134 consecutive patients aged 28-84 (mean age 69), with a total of 383 liver metastases. The major groups were liver metastases from colorectal cancer (88 patients) and liver metastases from breast cancer (20 patients), as well as metastases of miscellaneous primary tumors (26 patients). A total of 1048 laser applications were carried out. Cumulative survival times were calculated using the Kaplan-Meier method. All of the patients tolerated the procedure under local anesthesia well, and no severe complications or side effects were observed. During the follow-up period, 29 of the 134 patients treated died. The mean survival time was 35 months in the colorectal cancer group, 30 months in the breast cancer group, and 34 months in the group with miscellaneous primary tumors. The statistical assessment of the equality of survival distribution showed no significant differences between the three groups (Breslow test P = 0.35, Tarone-Ware test P = 0.49). These results suggest that in patients with liver metastases, local tumor destruction using minimally invasive percutaneous LITT under local anesthesia results in improved clinical outcomes, independently of the type of primary tumor.
Vogl
T J
TJ
Dept. of Radiology, Virchow Hospital, Humboldt University, Berlin, Germany.
Mack
M G
MG
Straub
R
R
Roggan
A
A
Felix
R
R
D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007089:Image Enhancement; D017075:Laser Coagulation / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D015642:Radiology, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D015996:Survival Rate; D016896:Treatment Outcome