Colorectal cancer liver metastases: long-term survival and progression-free survival after thermal ablation using magnetic resonance-guided laser-induced interstitial thermotherapy in 594 patients: analysis of prognostic factors.
OBJECTIVE
The purpose of this study was the evaluation of prognostic factors for long-term survival and progression-free survival (PFS) after treatment of colorectal cancer (CRC) liver metastases with magnetic resonance-guided laser-induced interstital thermotherapy (LITT).


METHODS
We included 594 patients (mean age, 61.2 years) with CRC liver metastases who were treated with LITT. The statistical analysis of the long-term survival and PFS were based on the Kaplan-Meier method. The Cox regression model tested different parameters that could be of prognostic value. The tested prognostic factors were the following: sex, age, the location of primary tumor, the number of metastases, the maximal diameter and total volume of metastases and necroses, the quotient of total volumes of metastases and necroses, the time of appearance of liver metastases and location in the liver, the TNM classification of CRC, extrahepatic metastases, and neoadjuvant treatments.


RESULTS
The median survival was 25 months starting from the date of the first LITT. The 1-, 2-, 3-, 4-, and 5-year survival rates were 78%, 50.1%, 28%, 16.4%, and 7.8%, respectively. The median PFS was 13 months. The 1-, 2-, 3-, 4-, and 5-year PFS rates were 51.3%, 35.4%, 30.7%, 25.4%, and 22.3%, respectively. The number of metastases and their maximal diameter were the most important prognostic factors for both long-term survival and PFS. Long-term survival was also highly influenced by the initial involvement of the lymph nodes.


CONCLUSIONS
For patients treated with LITT for CRC liver metastases, the number and size of metastases, together with the initial lymph node status, are significant prognostic factors for long-term survival.
From the *Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Frankfurt, Frankfurt am Main, Germany; †Department of Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt; ‡Department of Surgery, Johann Wolfgang Goethe University Frankfurt, Frankfurt am Main, Germany; and §Department of Radiology, Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Thomas J
TJ
Vogl
Alena
A
Dommermuth
Britta
B
Heinle
Nour-Eldin A
NE
Nour-Eldin
Thomas
T
Lehnert
Katrin
K
Eichler
Stephan
S
Zangos
Wolf O
WO
Bechstein
Nagy N N
NN
Naguib
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006979:Hyperthermia, Induced / Q000401:mortality* / Q000706:statistics & numerical data; D007834:Lasers; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy; D008137:Longitudinal Studies; D008207:Lymphatic Metastasis; D053783:Magnetic Resonance Imaging, Interventional / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome