Treatment of recurrent colorectal liver metastases by interstitial laser photocoagulation.
BACKGROUND
Hepatic resection improves survival in selected patients with colorectal liver metastases. The treatment of recurrent hepatic metastases after resection is controversial. Interstitial laser photocoagulation, performed under local anaesthesia, offers a minimally invasive option to repeat resection. The first series of patients with recurrent colorectal liver metastases treated with photo- coagulation is reported.


METHODS
Nineteen patients (five women and 14 men, median age 57 (range 44-71) years) who developed recurrent colorectal liver metastases after hepatectomy (five with bilateral disease) were treated with photocoagulation between 1993 and 1997. Fifteen patients also received chemotherapy (14 systemic, one hepatic arterial) before photocoagulation.


RESULTS
There were no major complications or deaths related to the treatment. Six patients developed minor complications related to the procedure but did not require any form of intervention. Median survival from commencement of photocoagulation was 16 (range 4-36) months.


CONCLUSIONS
Photocoagulation is a safe, minimally invasive therapy that may be used as an adjunct to chemotherapy and repeat resection in the treatment of recurrent colorectal liver metastases, and may lead to improved survival.
Shankar
A
A
Departments of Surgery, Imaging and Oncology, Royal Free and University College Medical School, Charles Bell House, 67-73 Riding House Street, London W1P 7LD, UK.
Lees
W R
WR
Gillams
A R
AR
Lederman
J A
JA
Taylor
I
I
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms; D005260:Female; D006801:Humans; D008028:Light Coagulation / Q000379:methods*; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome