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Complementary Use of Resection and Radiofrequency Ablation for the Treatment of Colorectal Liver Metastases: An Analysis of 395 Patients

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Abstract

Background

Liver resection and radiofrequency ablation (RFA) are two surgical options in the treatment of patients with colorectal liver metastases (CLM). The aim of this study was to analyze patient characteristics and outcomes after resection and RFA for CLM from a single center.

Methods

Between 2000 and 2010, 395 patients with CLM undergoing RFA (n = 295), liver resection (n = 94) or both (n = 6) were identified from a prospective IRB-approved database. Demographic, clinical and survival data were analyzed using univariate and multivariate analyses.

Results

RFA patients had more comorbidities, number of liver tumors and a higher incidence of extrahepatic disease compared to the Resection patients. The 5-year overall actual survival was 17 % in the RFA, 58 % in the Resection group (p = 0.001). On multivariate analysis, multiple liver tumors, dominant lesion >3 cm, and CEA >10 ng/ml were independent predictors of overall survival. Patients were followed for a median of 20 ± 1 months. Liver and extrahepatic recurrences were seen in 69 %, and 29 % of the patients in the RFA, and 40 %, and 19 % of the patients in the Resection group, respectively.

Conclusions

In this large surgical series, we described the characteristics and oncologic outcomes of patients undergoing resection or RFA for CLM. By having both options available, we were able to surgically treat a large number of patients presenting with different degrees of liver tumor burden and co-morbidities, and also manage liver recurrences in follow-up.

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Authors and Affiliations

  1. Department of General Surgery, and Hematology and Oncology, Cleveland Clinic, 9500 Euclid Avenue/F20, Cleveland, OH, 44195, USA

    Orhan Agcaoglu, Shamil Aliyev, Koray Karabulut, Galal El-Gazzaz, Federico Aucejo, Robert Pelley, Allan E. Siperstein & Eren Berber

Authors
  1. Orhan Agcaoglu
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  2. Shamil Aliyev
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  3. Koray Karabulut
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  4. Galal El-Gazzaz
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  5. Federico Aucejo
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  6. Robert Pelley
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  7. Allan E. Siperstein
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  8. Eren Berber
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Corresponding author

Correspondence to Eren Berber.

Additional information

This study was reported as an oral presentation at the annual meeting of the American College of Surgeons, October 25–28, 2011 in San Francisco, CA.

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Agcaoglu, O., Aliyev, S., Karabulut, K. et al. Complementary Use of Resection and Radiofrequency Ablation for the Treatment of Colorectal Liver Metastases: An Analysis of 395 Patients. World J Surg 37, 1333–1339 (2013). https://doi.org/10.1007/s00268-013-1981-1

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  • DOI: https://doi.org/10.1007/s00268-013-1981-1

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