Short-term Results of Radiofrequency Ablation for Liver Metastasis of Colorectal Cancer

Choi, Sung Il; Chang, Weon Young; Paik, Kwnag Yeool; Lee, Doo Seok; Oh, So Hyang; Kim, Jeong Han; Heo, Jin Seok; Lee, Woo Yong; Kim, Seung Hoon; Lee, Won Jae; Lim, Hyo Keun; Lim, Jae Hoon; Joh, Jae Won; Chun, Ho Kyung

Abstract

PURPOSE: Radiofrequency ablation (RFA) is emerging as a new therapeutic method for the management of hepatic malignancy. We report our experience on the use of his technique for the management of liver metastasis of colorectal cancer.
METHODS
All 32 colorectal cancer patients with synchronous or metachronous liver metastasis treated with RFA from May 1999 to May 2001 were reviewed using retrospective method including chart review and telephone interview. All patients were followed up postoperatively to assess complications, complete necrosis, local recurrence, and survival rate.
RESULTS
Forty-one RFA sessions were performed on 70 metastatic tumors in 32 patients. There were no treatment- related death. Two complications related with RFA treatment, one intrahepatic bleeding and one intrahepatic abscess, occurred in 41 sessions of RFA (6.2%). With a median follow-up of 13.5 months, tumors recurred in 7 of 70 lesions (10.0%) from 5 patients due to incomplete necrosis and intrahepatic new lesion or distant metastasis in 13 patients of 27 patients (51.9%) after complete necrosis. There were 5 deaths and the 2 year survival rate was 80.9%. Disease free survival was 90.1%, 75%, 26.4% in 6 months, 12 months and 24 months, respectively. Seven patients underwent liver resections successfully with the application of RFA for the residual lesions in the remaining contralateral lobe. In these patients, with 9.0 months median follow up, the disease recurred in 2 patients due to incomplete necrosis, while recurring in 2 patients after complete necrosis and 3 patients were survived without recurrence or distant metastasis.
CONCLUSIONS
Radiofrequency ablation is a safe, well-tolerated, and effective treatment for liver metastasis in colorectal cancer patients. The procedure can be used to treat the residual tumor load in the contralateral lobe following liver resection in those considered unresectable at first presentation. This new therapeutic strategy seems to increase surgical resectability in patients whose mass is determined unresectable. To approve the efficacy of RFA, more long- term follow up should be attempted.