European Radiology

, Volume 14, Issue 12, pp 2261–2267 | Cite as

Radio-frequency ablation of colorectal liver metastases in 167 patients

  • A. R. GillamsEmail author
  • W. R. Lees


The objective of this paper is to report our results from a prospective study of 167 patients with colorectal liver metastases treated with radio-frequency ablation (RFA). Three hundred fifty-four treatments were performed in 167 patients, 99 males, mean age 57 years (34–87). The mean number of metastases was 4.1 (1–27). The mean maximum diameter was 3.9 cm (1–12). Fifty-one (31%) had stable/treated extra-hepatic disease. Treatments were performed under general anaesthesia using US and CT guidance and single or cluster water-cooled electrodes (Valleylab, Boulder, CO). All patients had been rejected for or had refused surgical resection. Eighty percent received chemotherapy. Survival data were stratified by tumour burden at the time of first RFA. The mean number of RFA treatments was 2.1 (1–7). During a mean follow-up of 17 months (0–89), 72 developed new liver metastases and 71 developed progressive extra-hepatic disease. There were 14/354 (4%) major local complications and 22/354 (6%) minor local complications. For patients with ≤5 metastases, maximum diameter ≤5 cm and no extra-hepatic disease, the 5-year survival from the time of diagnosis was 30% and from the time of first thermal ablation was 26%. Given that the 5-year survival for operable patients is a median of 32%, our 5-year survival of 30% is promising.


Liver tumours Radio-frequency ablation Colorectal metastases 


  1. 1.
    Great Britain Office of National Statistics (1997) Cancer statistics registrations: registrations of cancer diagnosed in 1991, England and Wales. HSMO, EnglandGoogle Scholar
  2. 2.
    America Cancer Society (1999) Cancer facts and figures. American Cancer Society, Washington, pp 1–8Google Scholar
  3. 3.
    Hughes KS, Simon R, Songhorabodi S et al (1986) Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of patterns of recurrence. Surgery 100:278–284PubMedGoogle Scholar
  4. 4.
    Doci R, Gennari L, Bignami P et al (1991) One hundred patients with hepatic metastases from colorectal cancer treated by resection: analysis of prognostic determinants. Br J Surg 78:797–801PubMedGoogle Scholar
  5. 5.
    Steele G, Ravikumar T (1989) Resection of hepatic metastases from colorectal cancer. Ann Surg 210:127–138PubMedGoogle Scholar
  6. 6.
    Giacchetti S, Perpoint B, Zidani R et al (2000) Phase III multicenter trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first line treatment of metastatic colorectal cancer. J Clin Oncol 18:136–147PubMedGoogle Scholar
  7. 7.
    Douillard JY, V303 Study Group (2000) Irintoecan and high dose fluorouracil/leucovroin for metastatic colorectal cancer. Oncology 14:51–55PubMedGoogle Scholar
  8. 8.
    Bismuth H, Adam R, Levi F et al (1996) Resection of non-resectable liver metastases from colorectal cancer after neo-adjuvant chemotherapy. Ann Surg 224:509–522CrossRefPubMedGoogle Scholar
  9. 9.
    Shankar A, Leonard P, Renaut AJ et al (2001) Neoadjuvant therapy improves resectability rates for colorectal cancer. Ann R Coll Surg Engl 83:85–88PubMedGoogle Scholar
  10. 10.
    Solbiati L, Tizian I, Goldberg N et al (1997) Percutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients. Radiology 202:195–203PubMedGoogle Scholar
  11. 11.
    Denys A, de Baere T, Juoch V et al (2003) Radio-frequency tissue ablation of the liver: in vivo and ex vivo experiments with four different systems. Eur Radiol 10:2346–2352CrossRefGoogle Scholar
  12. 12.
    Buscarini E, Buscarini L (2004) Radiofrequency thermal ablation with expandable needle of focal liver malignancies: complication report. Eur Radiol 14:31–37CrossRefPubMedGoogle Scholar
  13. 13.
    Amin Z, Donald JJ, Masters A, Kant R, Steger AC, Bown SG, Lees WR (1993) Hepatic metastases: interstitial laser photocoagulation with real-time US monitoring and dynamic CT evaluation of treatment. Radiology 187:339–347PubMedGoogle Scholar
  14. 14.
    Amin Z, Thurrell W, Spencer GM et al (1993) Computed tomography-pathologic assessment of laser-induced necrosis in rat liver. Invest Radiol 28:1148–1154PubMedGoogle Scholar
  15. 15.
    Kelekis A, Terraz S, Roggan A et al (2003) Percutaneous treatment of liver tumors with an adapted probe for cool-tip, impedance-controlled radio-frequency ablation under open-magnet MR guidance: initial results. Eur Radiol 13:1100–1105PubMedGoogle Scholar
  16. 16.
    Fong Y, Cohen AM, Fortner JG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15:938–994PubMedGoogle Scholar
  17. 17.
    Solbiati L, Livraghi T, Goldberg SN et al (2001) Percutaneous RFA ablation of hepatic metastases from colorectal cancer: long term results in 117 patients. Radiology 221:159–166PubMedGoogle Scholar
  18. 18.
    Vogl T, Muller P, Meck M et al (1999) Liver metastases: interventional therapeutic techniques and results, state of the art. Eur Radiol 9:675–684CrossRefPubMedGoogle Scholar
  19. 19.
    Topal B, Kaufman L, Aerts R, Penninck F (2003) Patterns of failure following curative resection of colorectal liver metastases. EJSO 29:248–253CrossRefPubMedGoogle Scholar
  20. 20.
    Elias D, Ouellet J-F, Bellon N et al (2003) Extrahepatic disease does not contraindicate hepatectomy for colorectal liver metastases. Br J Surg 90:567–574CrossRefPubMedGoogle Scholar
  21. 21.
    Mulier S, Mulier P, Ni Y et al (2002) Complications of RFA coagulation of liver tumours. Br J Surg 89:1206–1222CrossRefPubMedGoogle Scholar
  22. 22.
    Rhim H, Dodd GD (1999) RFA thermal ablation of liver tumours. J Clin Ultrasound 27:221–229CrossRefPubMedGoogle Scholar
  23. 23.
    de Baere T, Risse PO, Kuoch V et al (2003) Adverse events during radio-frequency treatment of 582 hepatic tumours. Am J Roentgenol 181:695–700Google Scholar
  24. 24.
    Llovet JM, Vilana R, Bru C et al (2001) Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 33:1124–1129CrossRefPubMedGoogle Scholar
  25. 25.
    AR Gillams, Lees WR (2000) Survival following interstitial laser therapy for colorectal liver metastases. Dis Colon Rectum 43:656–661PubMedGoogle Scholar
  26. 26.
    Vogl TJ, Muller PK, Hammerstingl R et al (1995) Malignant liver tumors treated with MR imaging-guided laser-induced thermotherapy: technique and prospective results. Radiology 196:257–265PubMedGoogle Scholar
  27. 27.
    Livraghi T, Solbiati L, Meloni F et al (2003) Percutaneous radio-frequency ablation of liver metastases in potential candidates for resection: “the test-of-time” approach. Cancer 15:3027–3035CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of Medical ImagingThe Middlesex HospitalLondonUK

Personalised recommendations