title: Radiofrequency ablation of liver metastasis in patients with locally controlled pancreatic ductal adenocarcinoma.
abstract: OBJECTIVE
  To evaluate retrospectively the role of radiofrequency (RF) ablation for liver metastases arising from pancreatic ductal adenocarcinoma simultaneously with pancreatic resection or after curative resection in patient survival.
  
  
  METHODS
  RF ablation of liver metastases was performed on 34 patients with pancreatic ductal adenocarcinoma postoperatively after pancreatectomy or intraoperatively at pancreatectomy between December 2002 and June 2009. Criteria for RF ablation were liver metastasis ≤ 3 cm diameter in size, five or fewer lesions, and no definite suspicious lesion other than liver metastasis. Patient survival was assessed by the Kaplan-Meier method, and prognostic factors were analyzed.
  
  
  RESULTS
  Of the patients receiving RF ablation treatment (n = 34), 18 underwent one session of RF ablation, and 16 underwent more than one session. In each session, all the targeted lesions were successfully ablated by ultrasound-guided RF ablation. Median duration of follow-up was 15 months (range, 3-65 mo). The interval between pancreatic resection and liver metastasis was 3 months (range, 0-33 mo). Median survival time after liver metastasis was 14 months. Univariate analysis of factors affecting survival showed that better patient survival after RF ablation was associated with a single, < 2 cm diameter liver metastasis (P = .007) and well or moderate differentiation (P = .032). In multivariate analysis, a single < 2 cm diameter liver metastasis and good or moderate differentiation were independent predictors for longer patient survival (P = .027, P = .016).
  
  
  CONCLUSIONS
  RF ablation in liver metastasis occurring after locally controlled pancreatic ductal adenocarcinoma can be a safe and feasible strategy for extending survival in selected patients.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa-gu, Seoul 138-736, Korea.
authors.forename: Jae Berm
authors.initials: JB
authors.lastname: Park
authors.forename: Young Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Jihun
authors.initials: J
authors.lastname: Kim
authors.forename: Heung-Moon
authors.initials: HM
authors.lastname: Chang
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Kim
authors.forename: Song-Cheol
authors.initials: SC
authors.lastname: Kim
authors.forename: Pyo Nyun
authors.initials: PN
authors.lastname: Kim
authors.forename: Duck Jong
authors.initials: DJ
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D002454:Cell Differentiation; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010180:Pancreatectomy / Q000009:adverse effects / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden