Skip to main content

Advertisement

SpringerLink
Log in

Radiofrequency ablation of colorectal liver metastases

  • Published:
Abdominal Imaging Aims and scope Submit manuscript

Abstract

Background

Untreated patients with colorectal liver metastases rarely survive 3 years, and the 3-year survival rate for patients treated with chemotherapy is 3%. The best survival rates are for the small subgroup that has operable disease, i.e., 39% at 5 years. Radiofrequency ablation (RFA) offers a new opportunity to destroy liver metastases in patients who are not surgical candidates because of disease distribution or comorbidity.

Methods

Acceptance criteria were a maximum of four or five liver lesions with a maximum diameter of 4 or 5 cm and no evidence of active extrahepatic disease. Nearly all treatments were performed percutaneously using ultrasound, computed tomography, or magnetic resonance imaging (or some combination) for guidance and monitoring. RFA is a minimally invasive procedure that can be readily repeated. General anesthesia facilitates the procedure but is not essential. Multiple overlapping ablations are required to ensure optimal treatment in all but the smallest tumors.

Results

In our cohort of 167 patients with colorectal liver metastases, 73 fulfilled the optimal acceptance criteria (5 or fewer tumors that were ≤ 5 cm). The median survival periods were 38 months, with a 5-year survival rate of 30%, after the diagnosis of liver metastases and 31 months, with a 5-year survival rate of 25%, after the first ablation.

Conclusion

RFA increases the therapeutic options for patients with colorectal metastases. Until controlled trials can better define the role of RFA, there are several groups of patients who are not surgical candidates and can be considered for RFA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.

Similar content being viewed by others

References

  1. InstitutionalAuthorNameGreat Britain Office of National Statistics (1997) Cancer statistics registrations: registrations of cancer diagnosed in 1991, England and Wales HSMO London

    Google Scholar 

  2. InstitutionalAuthorNameAmerica Cancer Society (1999) Cancer facts, figures American Cancer Society Washington DC 1–8

    Google Scholar 

  3. R Doci L Gennari P Bignami et al. (1991) ArticleTitleOne hundred patients with hepatic metastases from colorectal cancer treated by resection: analysis of prognostic determinants Br J Surg 78 797–801 Occurrence Handle1873704

    PubMed  Google Scholar 

  4. G Steele T Ravikumar (1989) ArticleTitleResection of hepatic metastases from colorectal cancer Ann Surg 210 127–138 Occurrence Handle2667471

    PubMed  Google Scholar 

  5. S Giacchetti B Perpoint R Zidani et al. (2000) ArticleTitlePhase III multicenter trial of oxaliplatin added to chronomodulated fluorouracil-leucovorin as first line treatment of metastatic colorectal cancer J Clin Oncol 18 136–147 Occurrence Handle10623704

    PubMed  Google Scholar 

  6. JY Douillard (2000) ArticleTitleV303 Study Group. Irinotecan and high dose fluorouracil/leucovorin for metastatic colorectal cancer Oncology 14 51–55 Occurrence Handle11200150

    PubMed  Google Scholar 

  7. H Bismuth R Adam F Levi et al. (1996) ArticleTitleResection of non-resectable liver metastases from colorectal cancer after neo-adjuvant chemotherapy Ann Surg 224 509–522 Occurrence Handle10.1097/00000658-199610000-00009 Occurrence Handle8857855

    Article  PubMed  Google Scholar 

  8. A Shankar P Leonard AJ Renaut et al. (2001) ArticleTitleNeoadjuvant therapy improves respectability rates for colorectal cancer Ann R Coll Surg Engl 83 85–88 Occurrence Handle11320935

    PubMed  Google Scholar 

  9. L Solbiati I Tizian N Goldgerg et al. (1997) ArticleTitlePercutaneous US-guided radio-frequency tissue ablation of liver metastases: treatment and follow-up in 16 patients Radiology 202 195–203 Occurrence Handle8988211

    PubMed  Google Scholar 

  10. AR Gillams WR Lees (2000) ArticleTitleSurvival following interstitial laser therapy for colorectal liver metastases Dis Colon Rectum 43 656–661 Occurrence Handle10826427

    PubMed  Google Scholar 

  11. MF Meloni SN Goldberg T Livraghi et al. (2001) ArticleTitleHepatocellular carcinoma treated with radiofrequency ablation: comparison of pulse inversion contrast-enhanced harmonic sonography, contrast-enhanced power Doppler sonography, and helical CT AJR 177 375–380 Occurrence Handle11461867

    PubMed  Google Scholar 

  12. EJ Patterson CH Scudamore DA Owen et al. (1998) ArticleTitleRadiofrequency ablation of porcine liver in vivo: effects of blood flow and treatment time on lesion size Ann Surg 227 559–565 Occurrence Handle10.1097/00000658-199804000-00018 Occurrence Handle9563546

    Article  PubMed  Google Scholar 

  13. SN Goldberg PF Hahn KK Tanabe et al. (1998) ArticleTitlePercutaneous radiofrequency tissue ablation: does perfusion-mediated tissue cooling limit coagulation necrosis? J Vasc Interv Radiol 9 101–111 Occurrence Handle9468403

    PubMed  Google Scholar 

  14. T Baere Particlede B Bessoud C Dromain et al. (2002) ArticleTitlePercutaneous radiofrequency ablation of hepatic tumors during temporary venous occlusion AJR 178 53–59 Occurrence Handle11756087

    PubMed  Google Scholar 

  15. A Denys F Portier A Lamarre S Wicky (2001) ArticleTitleHepatic vascular occlusions and radiofrequency liver ablation: from animal experiment to clinical observation? AJR 177 1215–1216 Occurrence Handle11641208

    PubMed  Google Scholar 

  16. L Solbiati T Livraghi SN Goldberg et al. (2001) ArticleTitlePercutaneous RF ablation of hepatic metastases from colorectal cancer: long term results in 117 patients Radiology 221 159–166 Occurrence Handle11568334

    PubMed  Google Scholar 

  17. T Vogl P Muller M Meck et al. (1999) ArticleTitleLiver metastases: interventional therapeutic techniques and results, state of the art Eur Radiol 9 675–684 Occurrence Handle10.1007/s003300050732 Occurrence Handle10354884

    Article  PubMed  Google Scholar 

  18. M Mack R Straub K Eichler et al. (2001) ArticleTitlePercutaneous MR imaging-guided laser-induced thermotherapy of hepatic metastases Abdom Imaging 26 369–374 Occurrence Handle10.1007/s002610000197 Occurrence Handle11441548

    Article  PubMed  Google Scholar 

  19. T Baere Particlede PO Risse V Kuoch et al. (2003) ArticleTitleAdverse events during radio-frequency treatment of 582 hepatic tumours AJR 181 695–700 Occurrence Handle12933462

    PubMed  Google Scholar 

  20. S Mulier P Mulier Y Ni et al. (2002) ArticleTitleComplications of RF coagulation of liver tumours Br J Surg 89 1206–1222 Occurrence Handle10.1046/j.1365-2168.2002.02168.x Occurrence Handle12296886

    Article  PubMed  Google Scholar 

  21. Y Fong AM Cohen JG Fortner et al. (1997) ArticleTitleLiver Resection for Colorectal Metastases J Clin Oncol 15 938–946 Occurrence Handle9060531

    PubMed  Google Scholar 

  22. D Elias T Baere Particlede T Smayra et al. (2002) ArticleTitlePercutaneous radiofrequency thermoablation as an alternative to surgery for treatment of liver tumour recurrence after hepatectomy Br J Surg 89 752–756 Occurrence Handle10.1046/j.1365-2168.2002.02081.x Occurrence Handle12027986

    Article  PubMed  Google Scholar 

  23. A Oshowo A Gillams E Harrison et al. (2003) ArticleTitleComparison of resection and radiofrequency ablation for treatment of solitary colorectal liver metastases Br J Surg 90 1240–1243 Occurrence Handle10.1002/bjs.4264 Occurrence Handle14515293

    Article  PubMed  Google Scholar 

  24. T Livraghi L Solbiati F Meloni et al. (2003) ArticleTitlePercutaneous radio-frequency ablation of liver metastases in potential candidates for resection: “the test-of-time” approach Cancer 15 3027–3035 Occurrence Handle10.1002/cncr.11426

    Article  Google Scholar 

  25. B Topal L Kaufman R Aerts F Penninckx (2003) ArticleTitlePatterns of failure following curative resection of colorectal liver metastases Eur J Surg Oncol 29 248–253 Occurrence Handle10.1053/ejso.2002.1421 Occurrence Handle12657235

    Article  PubMed  Google Scholar 

  26. B Ohlsson U Stenram K Tranberg (1998) ArticleTitleResection of colorectal liver metastases: 25-year experience World J Surg 22 268–276 Occurrence Handle10.1007/s002689900381 Occurrence Handle9494419

    Article  PubMed  Google Scholar 

  27. D Elias J-F Ouellet N Bellon et al. (2003) ArticleTitleExtrahepatic disease does not contraindicate hepatectomy for colorectal liver metastases Br J Surg 90 567–574 Occurrence Handle10.1002/bjs.4071 Occurrence Handle12734864

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medical Imaging, The Middlesex Hospital, Mortimer Street, London, W1T 3AA, United Kingdom

    A. R. Gillams & W. R. Lees

Authors
  1. A. R. Gillams
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. R. Lees
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. R. Gillams.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gillams, A., Lees, W. Radiofrequency ablation of colorectal liver metastases. Abdom Imaging 30, 419–426 (2005). https://doi.org/10.1007/s00261-004-0256-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-004-0256-6

Keywords

Search

Navigation