Radiofrequency thermal ablation of hepatic metastases.
Percutaneous radiofrequency (RF) ablation is a promising therapeutic option for liver metastases, which may result in prolonged survival and chance for cure. Recent technological advancements provide larger coagulation volumes, allowing treatment of medium- and large-size metastases. Candidates are patients with metachronous liver metastases from colorectal or other primary cancers, in whom surgery is contraindicated and with one to four nodules each smaller than approx. 4 cm. We treated 109 patients with 172 colorectal metastases in the liver. Local control was obtained in 70.4% of lesions. Recurrence was significantly more frequent in lesions >3 cm. One major complication occurred (0.6% of sessions), a large bowel perforation requiring surgery. Seven minor complications did not require therapy. New metastases developed at follow-up in 50.4% of patients. Survival rates are 67% and 33% after 2 and 3 years, respectively; estimated median survival being 30 months. RF ablation advantages include minimal-invasiveness (no mortality, significantly lower complications), reduced costs and hospital stays compared to surgery, feasibility in non-surgical candidates, and the potential of repeated treatment if local recurrence occurs or new metastases develop.
Solbiati
L
L
Department of Radiology, General Hospital, 21052, Busto Arsizio, Italy. lusolbia@tin.it
Ierace
T
T
Tonolini
M
M
Osti
V
V
Cova
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology; D003131:Combined Modality Therapy; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018579:Patient Selection; D018084:Ultrasonography, Interventional