The trans-metastasis hepatectomy (through metastases previously ablated with radiofrequency): results of a 13-case study of colorectal cancer.
BACKGROUND
Curative trans-metastasis liver resection immediately following radiofrequency (RF) destruction is a new technique that enables the proposition of a curative approach to patients with bilateral, unresectable liver metastases (LM), when the only possible future hepatectomy plane passes through a LM. Firstly, the ill-sited LM, which is located in the only feasible future hepatectomy plane, is ablated using RF; the hepatectomy is then performed through this ablated LM.


OBJECTIVE
The aim of this study is to report the feasibility and efficacy of this new approach, known as post-RF-trans-metastasis-hepatectomy (PRFTMH).


METHODS
Thirteen patients with colorectal primary cancer were treated with PRFTMPH between January 2000 and May 2004. The mean number of LMs per patient was 10.7. Preoperative hypertrophy of the future remaining liver was achieved by selective portal vein embolization in eight patients.


RESULTS
The mortality rate was 7.6% (one death), and morbidity was 24%. No local recurrence was observed at the PRTMPH site after a mean follow-up of 19.4 months (range: 47-10), demonstrating the efficacy of this technique. All patients, except those who died postoperatively, are currently alive; the median survival has not yet been attained after a mean follow-up of 19.4 months.


CONCLUSIONS
TMPRFH is a new and safe technique, combining RF ablation and trans-RF-hepatectomy, which makes it possible to propose a curative approach in certain patients with non-resectable bilateral LMs.
Elias
Dominique
D
Department of Surgical Oncology, Institut Gustave Roussy, Cancer Center, Villejuif, cédex, France. elias@igr.fr
Manganas
Dimitri
D
Benizri
Emmanuel
E
Dufour
Fanny
F
Menegon
Paola
P
El Harroudi
Tijani
T
de Baere
Thierry
T
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011169:Portal Vein; D012008:Recurrence; D015996:Survival Rate; D016896:Treatment Outcome