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Journal of Gastrointestinal Surgery

, Volume 15, Issue 7, pp 1168–1172 | Cite as

Use of Intraoperative Ablation as an Adjunct to Surgical Resection in the Treatment of Recurrent Colorectal Liver Metastases

  • Anand Govindarajan
  • Dean Arnaoutakis
  • Michael D’Angelica
  • Peter J. Allen
  • Ronald P. DeMatteo
  • Leslie H. Blumgart
  • William R. Jarnagin
  • Yuman Fong
2010 SSAT Poster Presentation

Abstract

Objective

To evaluate the role of intraoperative ablation as an adjunct to resection in patients with recurrent colorectal liver metastases (rCLM).

Methods

All patients undergoing curative-intent reoperative surgery for rCLM from 1992 to 2009 at a tertiary cancer center were included. Overall survival (OS) and recurrence-free survival (RFS) were compared between patients treated with resection alone or in combination with ablation.

Results

A total of 112 reoperative hepatectomies were performed, of which 16 were combined with ablation. The proportion of patients treated with resection and ablation increased from 0% to 41%. Patients undergoing resection and ablation had a greater tumor burden (median, 4 vs. 1, p < 0.0001) and higher baseline clinical risk scores (median, 3 vs. 2, p = 0.065) than patients undergoing resection alone. Patients undergoing resection and ablation had lower intraoperative blood loss than patients undergoing resection alone (344 vs. 877 ml, p = 0.018). Five-year OS from the time of surgery was 48.6%. In multivariable analysis, there was no significant difference in OS or RFS based on the treatment modality.

Conclusion

In patients with rCLM, the use of intraoperative ablation can extend the limits of surgical resection in patients with disease that might otherwise not be amenable to complete resection.

Keywords

Colorectal cancer Liver metastases Ablation Surgery 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Anand Govindarajan
    • 1
  • Dean Arnaoutakis
    • 1
  • Michael D’Angelica
    • 1
  • Peter J. Allen
    • 1
  • Ronald P. DeMatteo
    • 1
  • Leslie H. Blumgart
    • 1
  • William R. Jarnagin
    • 1
  • Yuman Fong
    • 1
  1. 1.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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