Published in:
01-04-2012 | Oncology
Percutaneous stereotactic radiofrequency ablation of colorectal liver metastases
Published in: European Radiology | Issue 4/2012
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Objectives
To evaluate the outcome of patients with colorectal liver metastasis (CRLM) treated with stereotactic radiofrequency ablation (SRFA).
Methods
Following IRB approval, a retrospective evaluation of 98 SRFA treatment sessions of 189 CRLMs in 63 consecutive patients was performed. Local recurrence rate (LR), overall survival (OS) and disease-free survival (DFS) were analysed.
Results
LR was identified in 16% of the tumours (31/189), with no significant differences (P = 0.635) when comparing tumour sizes <3 cm (17.7%), 3–5 cm (11.1%) and >5 cm (17.4%). The median OS from SRFA treatment was 33.2 months after a mean follow-up of 25 months (range 2–66); the corresponding 1-, 3- and 5- year survival rates were 87%, 44% and 27%. The median OS was significantly different when comparing unresectable and resectable patients (27 vs. 58 months, P = 0.002) with OS rates of 92%, 66% and 48% at 1, 3 and 5 years in resectable patients. Tumour size did not affect OS and DFS.
Conclusion
Due to the favourable outcome, SRFA challenges resection as first-line local treatment of patients with CRLM. As long as randomised studies are pending, we recommend entering an individual decision-making process with every patient.
Key Points
• Large colorectal liver metastases can be effectively treated by stereotactic radiofrequency ablation (SRFA).
• Using SRFA the overall survival is not affected by tumour size.
• SRFA achieves similar overall and disease-free survival rates as surgical resection.
• SRFA challenges surgical resection as the first-line treatment for colorectal liver metastases.