Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation |
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Authors: | A R Gillams W R Lees |
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Institution: | (1) University College Hospital and University College London Medical School, London, UK;(2) Special Xray, Podium 2, UCH, 235 Euston Road, London, NW1 2BU, UK |
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Abstract: | There is little published long-term survival data for patients with colorectal liver metastases treated with radiofrequency
ablation (RFA). We present a multivariate analysis of 5-year survival in 309 patients (198 male, aged 64 (24–92)) treated
at 617 sessions. Our standard protocol used internally cooled electrodes introduced percutaneously under combined US and CT
guidance/monitoring. The number and size of liver metastases, the presence and location of extrahepatic disease, primary resection,
clinical, chemotherapy and follow-up data were recorded. Data analysis was performed using SPSS v.10. On multivariate analysis,
significant survival factors were the presence of extrahepatic disease (p < 0.001) and liver tumour volume (p = 0.001). For 123 patients with five or less metastases of 5 cm or less maximum diameter and no extrahepatic disease median
survival was 46 and 36 months from liver metastasis diagnosis and ablation, respectively; corresponding 3- and 5-year survival
rates were 63%, 34% and 49%, 24%. Sixty-nine patients had three or less tumours of below 3.5 cm in diameter and their 5-year
survival from ablation was 33%. There were 23/617(3.7%) local complications requiring intervention. Five-year survival of
24–33% post ablation in selected patients is superior to any published chemotherapy data and approaches the results of liver
resection. |
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Keywords: | Radiofrequency ablation Secondary liver tumours Colorectal liver metastases Thermal ablation |
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