title: Radiofrequency ablation as locoregional therapy for unresectable hepatic malignancies: initial results in 24 patients with 5-years follow-up.
abstract: Radiofrequency ablation (RFA) is one treatment modality for unresectable liver metastases. Patients with hepatic malignancies (n = 24) underwent elective RFA. All tumors were ablated with a curative intent, with a margin of 1 cm, in a single session of RFA. The median diameter of tumor was 3.1 cm (range 1.7-6.9 cm). Studied patients were not candidates for resection due to multifocal hepatic disease, extrahepatic disease, proximity to major vascular structures or presence of cirrhosis with functional hepatic reserve inadequate to tolerate major hepatic resection. Complete tumor necrosis was achieved in 87.5% and tumor recurred in 3 patients (12.5%) with lesions larger than 5 cm. Distant intrahepatic recurrence was diagnosed in another 4 (16.7%). Distant metastases were found in 7 (29.2%) patients. Four of these 7 patients had also distant intrahepatic recurrence of disease. Two and 5-years survival rates were 41.7% (10 patients) and 8.3% (2 patients) respectively. RFA is safe and effective option for patients with unresectable hepatic malignancies smaller than 5 cm without distant metastatic disease. RF ablation resulted in complete tumor necrosis in 87.5% with 2 and 5-years survival rates much higher than with chemotherapy alone or only supportive therapy, when survival is measured in weeks or months. If RFA is unavailable, percutaneous ethanol injection therapy can be done but with inferior survival rates.
authors.affiliation: Department of Surgery, Division of Abdominal Surgery, University Hospital Center "Zagreb", Zagreb, Croatia.
authors.forename: Mate
authors.initials: M
authors.lastname: Majerović
authors.forename: Goran
authors.initials: G
authors.lastname: Augustin
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Jelincić
authors.forename: Damir
authors.initials: D
authors.lastname: Buković
authors.forename: Tihomir
authors.initials: T
authors.lastname: Kekez
authors.forename: Petar
authors.initials: P
authors.lastname: Matosević
authors.forename: Dubravko
authors.initials: D
authors.lastname: Smud
authors.forename: Emil
authors.initials: E
authors.lastname: Kinda
authors.forename: Ante Zvonimir
authors.initials: AZ
authors.lastname: Golem
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000401:mortality; D000431:Ethanol / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000431:Ethanol