Colorectal carcinoma metastases in liver: laser-induced interstitial thermotherapy--local tumor control rate and survival data.
OBJECTIVE
To evaluate the local tumor control and survival data for magnetic resonance (MR) imaging-guided laser-induced interstitial thermotherapy (LITT) of colorectal liver metastases.


METHODS
MR imaging-guided LITT was performed in 603 patients (mean age, 61.2 years) with 1,801 liver metastases of colorectal cancer. Survival rates were calculated by means of the Kaplan-Meier method. Local tumor control and tumor volume were evaluated with nonenhanced and contrast material-enhanced MR imaging. Indications for the procedure were defined for patients with five or fewer metastases, none of which were larger than 5 cm in diameter. The indications included recurrent liver metastases after partial liver resection in 37.6% of study patients, metastases in both liver lobes in 32.5%, locally nonresectable lesions in 11.3%, general contraindications for surgery in 4.6%, and refusal to undergo surgical resection in 13.9%.


RESULTS
Local recurrence rate at 6-month follow-up was 1.9% (nine of 474) for metastases up to 2 cm in diameter, 2.4% (13 of 539) for metastases 2.1-3.0 cm in diameter, 1.2% (four of 327) for metastases 3.1-4.0 cm in diameter, and 4.4% (13 of 294) for metastases larger than 4 cm in diameter. The mean survival rate for all treated patients, with calculation started on the date of diagnosis of the metastases (which were treated with LITT) was 4.4 years (95% CI: 4.0, 4.8) (1-year survival, 94%; 2-year survival, 77%; 3-year survival, 56%; 5-year survival, 37%). Median survival was 3.5 years (95% CI: 3.0, 3.9). Mean survival after the first LITT treatment was 3.8 years (95% CI: 3.4, 4.2). Median survival was 2.9 years (95% CI: 2.4, 3.3).


CONCLUSIONS
MR imaging-guided LITT yields high local tumor control and survival rates in well-selected patients with limited liver metastases of colorectal carcinoma.
Vogl
Thomas J
TJ
Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. t.vogl@em.uni-frankfurt.de
Straub
Ralf
R
Eichler
Katrin
K
Söllner
Oliver
O
Mack
Martin G
MG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D010166:Palliative Care; D015996:Survival Rate; D016896:Treatment Outcome