Radiofrequency ablation for metachronous liver metastasis from colorectal cancer after curative surgery.
BACKGROUND
We compared outcomes of surgery and radiofrequency thermal ablation (RFA) in patients with metachronous liver metastases.


METHODS
Between October 1995 and December 2005, 59 patients underwent hepatic resection and 30 underwent RFA for metachronous liver metastases. Patients with extra-hepatic metastases, those who underwent both types of treatment, and those with synchronous hepatic metastasis were excluded.


RESULTS
The two groups had similar mean age, sex ratio, comorbid medical conditions, primary disease stage, and frequency of solitary metastases. Preoperative mean serum carcinoembryonic antigen (CEA) level was significantly higher in the RFA group (13.4 ng/mL vs. 7.7 ng/mL; p = 0.02). Mean diameter of hepatic metastases was significantly greater in the resection than in the RFA group (3.1 cm vs. 2.0 cm; p = 0.001). Recurrence after treatment of metastasis was observed in 18 of 30 (60.0%) RFA and 33 of 59 (56%) resection patients. Local recurrence at the RFA site was observed in 7 of 30 (23%) patients. Time to recurrence (15 vs. 8 months, p = 0.02) and overall survival (56 vs. 36 months, p = 0.005) were significantly longer in the resection than in the RFA group. In the 69 patients with solitary metastases of diameter </=3 cm, time to recurrence (p = 0.004) and overall survival were significantly greater in the resection group.


CONCLUSIONS
Compared with hepatic resection, RFA for metachronous hepatic metastases from colorectal cancer was associated with higher local recurrence and shorter recurrence-free and overall survival rates, even in patients with solitary, small (</=3 cm) lesions.
Park
In Ja
IJ
Department of Surgery, University of Ulsan College of Medicine, and Colorectal Cancer Team, Asan Cancer Center, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea.
Kim
Hee Cheol
HC
Yu
Chang Sik
CS
Kim
Pyo Nyun
PN
Won
Hyung Jin
HJ
Kim
Jin Cheon
JC
D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D015642:Radiology, Interventional; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome