Skip to main content

Advertisement

SpringerLink
Log in

Radio-frequency ablation of colorectal liver metastases in 167 patients

  • Hepatobiliary-Pancreas
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

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.

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

Similar content being viewed by others

References

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

    Google Scholar 

  2. America Cancer Society (1999) Cancer facts and figures. American Cancer Society, Washington, pp 1–8

    Google Scholar 

  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 100:278–284

    CAS  PubMed  Google Scholar 

  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 78:797–801

    CAS  PubMed  Google Scholar 

  5. Steele G, Ravikumar T (1989) Resection of hepatic metastases from colorectal cancer. Ann Surg 210:127–138

    PubMed  Google Scholar 

  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 18:136–147

    CAS  PubMed  Google Scholar 

  7. Douillard JY, V303 Study Group (2000) Irintoecan and high dose fluorouracil/leucovroin for metastatic colorectal cancer. Oncology 14:51–55

    CAS  PubMed  Google Scholar 

  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 224:509–522

    Article  CAS  PubMed  Google Scholar 

  9. Shankar A, Leonard P, Renaut AJ et al (2001) Neoadjuvant therapy improves resectability rates for colorectal cancer. Ann R Coll Surg Engl 83:85–88

    CAS  PubMed  Google Scholar 

  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 202:195–203

    CAS  PubMed  Google Scholar 

  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 10:2346–2352

    Article  Google Scholar 

  12. Buscarini E, Buscarini L (2004) Radiofrequency thermal ablation with expandable needle of focal liver malignancies: complication report. Eur Radiol 14:31–37

    Article  PubMed  Google Scholar 

  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 187:339–347

    CAS  PubMed  Google Scholar 

  14. Amin Z, Thurrell W, Spencer GM et al (1993) Computed tomography-pathologic assessment of laser-induced necrosis in rat liver. Invest Radiol 28:1148–1154

    CAS  PubMed  Google Scholar 

  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 13:1100–1105

    PubMed  Google Scholar 

  16. Fong Y, Cohen AM, Fortner JG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15:938–994

    CAS  PubMed  Google Scholar 

  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 221:159–166

    CAS  PubMed  Google Scholar 

  18. Vogl T, Muller P, Meck M et al (1999) Liver metastases: interventional therapeutic techniques and results, state of the art. Eur Radiol 9:675–684

    Article  CAS  PubMed  Google Scholar 

  19. Topal B, Kaufman L, Aerts R, Penninck F (2003) Patterns of failure following curative resection of colorectal liver metastases. EJSO 29:248–253

    Article  CAS  PubMed  Google Scholar 

  20. Elias D, Ouellet J-F, Bellon N et al (2003) Extrahepatic disease does not contraindicate hepatectomy for colorectal liver metastases. Br J Surg 90:567–574

    Article  CAS  PubMed  Google Scholar 

  21. Mulier S, Mulier P, Ni Y et al (2002) Complications of RFA coagulation of liver tumours. Br J Surg 89:1206–1222

    Article  CAS  PubMed  Google Scholar 

  22. Rhim H, Dodd GD (1999) RFA thermal ablation of liver tumours. J Clin Ultrasound 27:221–229

    Article  CAS  PubMed  Google Scholar 

  23. de Baere T, Risse PO, Kuoch V et al (2003) Adverse events during radio-frequency treatment of 582 hepatic tumours. Am J Roentgenol 181:695–700

    Google Scholar 

  24. Llovet JM, Vilana R, Bru C et al (2001) Increased risk of tumor seeding after percutaneous radiofrequency ablation for single hepatocellular carcinoma. Hepatology 33:1124–1129

    Article  CAS  PubMed  Google Scholar 

  25. AR Gillams, Lees WR (2000) Survival following interstitial laser therapy for colorectal liver metastases. Dis Colon Rectum 43:656–661

    CAS  PubMed  Google Scholar 

  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 196:257–265

    CAS  PubMed  Google Scholar 

  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 15:3027–3035

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

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

    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.R., Lees, W.R. Radio-frequency ablation of colorectal liver metastases in 167 patients. Eur Radiol 14, 2261–2267 (2004). https://doi.org/10.1007/s00330-004-2416-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-004-2416-z

Keywords

Search

Navigation