Laser ablation of liver metastases from colorectal cancer with MR thermometry: 5-year survival.
OBJECTIVE
To determine technical success, technique effectiveness, complications, and survival after laser ablation of liver metastases from colorectal cancer.


METHODS
Eighty-seven consecutive patients (65 men and 22 women; mean age, 62.8 years) with 180 liver metastases from colorectal carcinoma were included between 1998 and 2005. They underwent laser ablation with magnetic resonance (MR) thermometry in 170 sessions. Indications for laser ablation were locally unresectable tumors (16.1%), metastases in both liver lobes (34.5%), and refusal of surgery and/or general contraindications to surgery (49.4%). Technical success, technique effectiveness, and complication and survival rates were evaluated retrospectively.


RESULTS
Technical success was achieved in 178 of 180 sessions (99%). Follow-up after 24-48 hours demonstrated an effectiveness rate of 85.6%. Local tumor progression rate was 10% after 6 months. Major complications included large pleural effusion, large subcapsular hematoma, abscess, large pneumothorax, pleuritis with fever, intrahepatic hemorrhage, and biloma. Mean survival from the time of diagnosis of the primary tumor was 50.6 months for all patients treated (95% CI, 44.9-56.3 months). Median survival time was 54 months and survival rates were 95.7% at 1 year, 86.2% at 2 years, 72.4% at 3 years, 50.1% at 4 years, and 33.4% at 5 years. The mean survival time after the first treatment was 31.1 months (95% CI, 26.9-35.3 months).


CONCLUSIONS
Laser ablation of liver metastases of colorectal cancer with MR thermometry appears safe and efficacious. Although the results are encouraging, direct comparison with other ablative modalities in a prospective clinical trial would be necessary to definitely show one modality is superior.
Puls
Ralf
R
Department of Diagnostic Radiology and Neuroradiology, Ernst Moritz Arndt University, Friedrich-Loeffler-Strasse 23a, 17487 Greifswald, Germany. puls@uni-greifswald.de
Langner
Soenke
S
Rosenberg
Christian
C
Hegenscheid
Katrin
K
Kuehn
Jens Peter
JP
Noeckler
Kai
K
Hosten
Norbert
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D053685:Laser Therapy / Q000401:mortality*; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D025321:Surgery, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D016019:Survival Analysis; D015996:Survival Rate; D013817:Thermography / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome