title: Local tumor progression patterns after radiofrequency ablation of colorectal cancer liver metastases.
abstract: OBJECTIVE
  We aimed to evaluate patterns of local tumor progression (LTP) after radiofrequency ablation (RF ablation) of colorectal cancer liver metastases (CRCLM) and to highlight the percentage of LTP not attributable to lesion size or RF ablation procedure-related factors (heat sink or insufficient ablation margin).
  
  
  METHODS
  CRCLM treated by RF ablation at a single tertiary care center from 2004-2012, with a minimum of six months of postprocedure follow-up, were included in this retrospective study. LTP morphology was classified as focal nodular (<90° of ablation margin), circumferential (>270°), or crescentic (90°-270°). Initial metastasis size, minimum ablation margin size, morphology of LTP, presence of a heat sink, and time to progression were recorded independently by two radiologists.
  
  
  RESULTS
  Thirty-two of 127 RF ablation treated metastases (25%) with a mean size of 23 mm (standard deviation 12 mm) exhibited LTP. Fifteen of 32 LTPs (47%) were classified as focal nodular, with seven having no procedure-related factor to explain recurrence. Ten of 32 LTPs (31%) were circumferential, with four having no procedure-related factor to explain recurrence. Seven of 32 LTPs (22%) were crescentic, with two having no procedure-related factor to explain recurrence. Of the 13 lesions without any obvious procedure-related reason for LTP, six (46%) were <3 cm in size.
  
  
  CONCLUSIONS
  Although LTP in RF ablation treated CRCLM can often be explained by procedure-related factors or size of the lesion, in this study up to six (5%) of the CRCLM we treated showed LTP without any reasonable cause.
authors.affiliation: Department of Radiology, University of Ottawa, Canada and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. aniakielar@gmail.com.
authors.forename: Marc
authors.initials: M
authors.lastname: Napoleone
authors.forename: Ania Z
authors.initials: AZ
authors.lastname: Kielar
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hibbert
authors.forename: Sameh
authors.initials: S
authors.lastname: Saif
authors.forename: Benjamin Y
authors.initials: BY
authors.lastname: Kwan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome