title: Profile of serum factors and disseminated tumor cells before and after radiofrequency ablation compared to resection of colorectal liver metastases - a pilot study.
abstract: OBJECTIVE
  The degree of systemic response after hepatic radiofrequency ablation (RFA) has not been well-compared to liver resection so far. This pilot study was designed to examine whether RFA, compared to liver resection, significantly varies concerning dissemination of circulating tumor cells and induction of different pro-inflammatory markers and liver-specific growth factors.
  
  
  METHODS
  Patients with colorectal liver metastases were treated with RFA, a combination of RFA and resection or liver resection only. Blood samples of 18 patients were obtained at different time points and interleukin (IL)-6, hepatocyte growth factor (HGF) and 70-kD heat shock protein (HSP70) serum levels were determined by ELISA. Circulating tumor cells were detected with reverse transcription-polymerase chain reaction (RT-PCR) amplification of cytokeratin 20 (CK20) mRNA (CK20 RT-PCR).
  
  
  RESULTS
  The detection of circulating tumor cells was not significantly different, but in two patients RFA induced tumor cell dissemination. Serum levels of IL-6 were strongly elevated after the operation without any significant differences between the treatment groups. The HGF ratio was significantly higher after RFA+resection compared to resection-alone and the HSP70 ratio also showed significantly higher values after RFA compared to resection alone. High postoperative IL-6 and HGF levels negatively influenced overall survival (OS) independently of the treatment group.
  
  
  CONCLUSIONS
  This pilot study demonstrates that RFA might influence tumor cell dissemination. There exist detectable differences in serum factors between RFA and liver resection after the operation but this did not influence the overall survival of the patients. For all patients, high postoperative IL-6 and HGF levels are negative prognostic markers.
authors.affiliation: Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany sebastian.hinz@uksh-kiel.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Hinz
authors.affiliation: Clinic for General, Thoracic and Visceral Surgery, Klinikum Osnabrück, Osnabrück, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Tepel
authors.affiliation: Institute for Experimental Cancer Research, Cancer Center North, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Röder
authors.affiliation: Institute for Experimental Cancer Research, Cancer Center North, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Kalthoff
authors.affiliation: Department of General and Thoracic Surgery, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D018840:HSP70 Heat-Shock Proteins / Q000097:blood; D006498:Hepatectomy; D017228:Hepatocyte Growth Factor / Q000097:blood; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology; D009360:Neoplastic Cells, Circulating; D010865:Pilot Projects; D011379:Prognosis; D016019:Survival Analysis
chemical_list: C066855:HGF protein, human; D018840:HSP70 Heat-Shock Proteins; D015850:Interleukin-6; D017228:Hepatocyte Growth Factor
keywords: HGF; HSP-70; IL-6; Radiofrequency ablation; colorectal liver metastases; disseminated tumor cells; liver resection