Skip to main content
Erschienen in: Japanese Journal of Radiology 7/2012

01.08.2012 | Original article

Radiofrequency ablation for colorectal liver metastases: prognostic factors in non-surgical candidates

verfasst von: Ayumi Hamada, Koichiro Yamakado, Atsuhiro Nakatsuka, Junji Uraki, Masataka Kashima, Haruyuki Takaki, Takashi Yamanaka, Yasuhiro Inoue, Masato Kusunoki, Kan Takeda

Erschienen in: Japanese Journal of Radiology | Ausgabe 7/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To determine prognostic factors in patients with colorectal liver metastases who were not surgical candidates and received liver radiofrequency (RF) ablation.

Materials and methods

RF ablation was done for 141 colorectal liver metastases in 84 patients. There were 63 (75.0 %, 63/84) males and 21 (25.0 %, 21/84) females, with a mean age of 64.6 ± 10.3. The mean maximum tumor diameter was 2.3 ± 1.4 cm (range 0.5–9.0 cm). Extrahepatic metastases were associated at the time of liver RF ablation in 23 patients (27.4 %, 23/84), and 12 (14.3 %, 12/84) had lung metastases considered controllable by planned lung RF ablation. Prognostic factors were evaluated by univariate and multivariate analyses.

Results

There was no procedure-related mortality. The 1-, 3-, and 5-year overall survival rates were 90.6 % (95 %CI, 83.9–97.2 %), 44.9 % (95 %CI, 31.8–57.9 %), and 20.8 % (95 %CI, 7.3–34.3 %), respectively, with a median survival of 34.9 months. The univariate analysis showed that tumor diameter larger than 3 cm, tumor multiplicity, uncontrollable extrahepatic disease, and previous chemotherapy history were significantly worse prognostic factors. The former three factors remained significant for worse prognosis in the multivariate Cox model. Extrahepatic disease was not a prognostic factor when it could be controlled.

Conclusion

Tumor size and number, and uncontrollable extrahepatic metastases were significant prognostic factors.
Literatur
1.
Zurück zum Zitat Ballantyne GH, Quin J. Surgical treatment of liver metastases in patients with colorectal cancer. Cancer. 1993;71:4252–66.PubMedCrossRef Ballantyne GH, Quin J. Surgical treatment of liver metastases in patients with colorectal cancer. Cancer. 1993;71:4252–66.PubMedCrossRef
2.
Zurück zum Zitat Paschos KA, Bird N. Current diagnostic and therapeutic approaches for colorectal cancer liver metastasis. Hippokratia. 2008;12:132–8.PubMed Paschos KA, Bird N. Current diagnostic and therapeutic approaches for colorectal cancer liver metastasis. Hippokratia. 2008;12:132–8.PubMed
3.
Zurück zum Zitat Wagner JS, Adson MA, Van Heerden JA, Adson MH, Ilstrup DM. The natural history of hepatic metastases from colorectal cancer. A comparison with resective treatment. Ann Surg. 1984;199:502–8.PubMedCrossRef Wagner JS, Adson MA, Van Heerden JA, Adson MH, Ilstrup DM. The natural history of hepatic metastases from colorectal cancer. A comparison with resective treatment. Ann Surg. 1984;199:502–8.PubMedCrossRef
4.
Zurück zum Zitat Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J. Factors influencing the natural history of colorectal liver metastases. Lancet. 1994;343:1405–10.PubMedCrossRef Stangl R, Altendorf-Hofmann A, Charnley RM, Scheele J. Factors influencing the natural history of colorectal liver metastases. Lancet. 1994;343:1405–10.PubMedCrossRef
5.
Zurück zum Zitat Malafosse R, Penna C, Sa Cunha A, Nordlinger B. Surgical management of hepatic metastases from colorectal malignancies. Ann Oncol. 2001;12:887–94.PubMedCrossRef Malafosse R, Penna C, Sa Cunha A, Nordlinger B. Surgical management of hepatic metastases from colorectal malignancies. Ann Oncol. 2001;12:887–94.PubMedCrossRef
6.
Zurück zum Zitat Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg. 1995;19:59–71.PubMedCrossRef Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg. 1995;19:59–71.PubMedCrossRef
7.
Zurück zum Zitat Choti MA, Sitzmann JV, Tiburi MF, Sumetchotimetha W, Rangsin R, Schulick RD, et al. Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg. 2002;235:759–66.PubMedCrossRef Choti MA, Sitzmann JV, Tiburi MF, Sumetchotimetha W, Rangsin R, Schulick RD, et al. Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg. 2002;235:759–66.PubMedCrossRef
8.
Zurück zum Zitat Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG, et al. Liver resection for colorectal metastases. J Clin Oncol. 1997;15:938–46.PubMed Fong Y, Cohen AM, Fortner JG, Enker WE, Turnbull AD, Coit DG, et al. Liver resection for colorectal metastases. J Clin Oncol. 1997;15:938–46.PubMed
9.
Zurück zum Zitat Bismuth H, Adam R, Lévi F, Farabos C, Waechter F, Castaing D, et al. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg. 1996;224:509–20.PubMedCrossRef Bismuth H, Adam R, Lévi F, Farabos C, Waechter F, Castaing D, et al. Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg. 1996;224:509–20.PubMedCrossRef
10.
Zurück zum Zitat Gallagher DJ, Kemeny N. Metastatic colorectal cancer: from improved survival to potential cure. Oncology. 2010;78:237–48.PubMedCrossRef Gallagher DJ, Kemeny N. Metastatic colorectal cancer: from improved survival to potential cure. Oncology. 2010;78:237–48.PubMedCrossRef
11.
Zurück zum Zitat Liu JG, Wang YJ, Du Z. Radiofrequency ablation in the treatment of small hepatocellular carcinoma: a meta analysis. World J Gastroenterol. 2010;16:3450–6.PubMedCrossRef Liu JG, Wang YJ, Du Z. Radiofrequency ablation in the treatment of small hepatocellular carcinoma: a meta analysis. World J Gastroenterol. 2010;16:3450–6.PubMedCrossRef
12.
Zurück zum Zitat Kudo M. Radiofrequency ablation for hepatocellular carcinoma: updated review in 2010. Oncology. 2010;78:113–24.PubMedCrossRef Kudo M. Radiofrequency ablation for hepatocellular carcinoma: updated review in 2010. Oncology. 2010;78:113–24.PubMedCrossRef
13.
Zurück zum Zitat Veltri A, Sacchetto P, Tosetti I, Pagano E, Fava C, Gandini G. Radiofrequency ablation of colorectal liver metastases: small size favorably predicts technique effectiveness and survival. Cardiovasc Intervent Radiol. 2008;31:948–56.PubMedCrossRef Veltri A, Sacchetto P, Tosetti I, Pagano E, Fava C, Gandini G. Radiofrequency ablation of colorectal liver metastases: small size favorably predicts technique effectiveness and survival. Cardiovasc Intervent Radiol. 2008;31:948–56.PubMedCrossRef
14.
Zurück zum Zitat Solbiati L, Livraghi T, Goldberg SN, Ierace T, Meloni F, Dellanoce M, et al. Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology. 2001;221:159–66.PubMedCrossRef Solbiati L, Livraghi T, Goldberg SN, Ierace T, Meloni F, Dellanoce M, et al. Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology. 2001;221:159–66.PubMedCrossRef
15.
Zurück zum Zitat Hur H, Ko YT, Min BS, Kim KS, Choi JS, Sohn SK, et al. Comparative study of resection and radiofrequency ablation in the treatment of solitary colorectal liver metastases. Am J Surg. 2009;197:728–36.PubMedCrossRef Hur H, Ko YT, Min BS, Kim KS, Choi JS, Sohn SK, et al. Comparative study of resection and radiofrequency ablation in the treatment of solitary colorectal liver metastases. Am J Surg. 2009;197:728–36.PubMedCrossRef
16.
Zurück zum Zitat Aloia TA, Vauthey JN, Loyer EM, Ribero D, Pawlik TM, Wei SH, et al. Solitary colorectal liver metastasis: resection determines outcome. Arch Surg. 2006;141:460–6.PubMedCrossRef Aloia TA, Vauthey JN, Loyer EM, Ribero D, Pawlik TM, Wei SH, et al. Solitary colorectal liver metastasis: resection determines outcome. Arch Surg. 2006;141:460–6.PubMedCrossRef
17.
Zurück zum Zitat Berber E, Pelley R, Siperstein AE. Predictors of survival after radiofrequency thermal ablation of colorectal cancer metastases to the liver: a prospective study. J Clin Oncol. 2005;23:1358–64.PubMedCrossRef Berber E, Pelley R, Siperstein AE. Predictors of survival after radiofrequency thermal ablation of colorectal cancer metastases to the liver: a prospective study. J Clin Oncol. 2005;23:1358–64.PubMedCrossRef
18.
Zurück zum Zitat Gillams AR, Lees WR. Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation. Eur Radiol. 2009;19:1206–13.PubMedCrossRef Gillams AR, Lees WR. Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation. Eur Radiol. 2009;19:1206–13.PubMedCrossRef
19.
Zurück zum Zitat Siperstein AE, Berber E, Ballem N, Parikh RT. Survival after radiofrequency ablation of colorectal liver metastases: 10-year experience. Ann Surg. 2007;246:559–65.PubMedCrossRef Siperstein AE, Berber E, Ballem N, Parikh RT. Survival after radiofrequency ablation of colorectal liver metastases: 10-year experience. Ann Surg. 2007;246:559–65.PubMedCrossRef
20.
Zurück zum Zitat Mainenti PP, Mancini M, Mainolfi C, Camera L, Maurea S, Manchia A, et al. Detection of colo-rectal liver metastases: prospective comparison of contrast enhanced US, multidetector CT, PET/CT, and 1.5 Tesla MR with extracellular and reticulo-endothelial cell specific contrast agents. Abdom Imaging. 2010;35:511–21.PubMedCrossRef Mainenti PP, Mancini M, Mainolfi C, Camera L, Maurea S, Manchia A, et al. Detection of colo-rectal liver metastases: prospective comparison of contrast enhanced US, multidetector CT, PET/CT, and 1.5 Tesla MR with extracellular and reticulo-endothelial cell specific contrast agents. Abdom Imaging. 2010;35:511–21.PubMedCrossRef
21.
Zurück zum Zitat Goldberg SN, Grassi CJ, Cardella JF, Charboneau JW, Dodd GD 3rd, Dupuy DE, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol. 2009;20:S377–90.PubMedCrossRef Goldberg SN, Grassi CJ, Cardella JF, Charboneau JW, Dodd GD 3rd, Dupuy DE, et al. Image-guided tumor ablation: standardization of terminology and reporting criteria. J Vasc Interv Radiol. 2009;20:S377–90.PubMedCrossRef
22.
Zurück zum Zitat Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:S199–202.PubMedCrossRef Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of Interventional Radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:S199–202.PubMedCrossRef
23.
Zurück zum Zitat Pulitanò C, Bodingbauer M, Aldrighetti L, de Jong MC, Castillo F, Schulick RD, et al. Liver resection for colorectal metastases in presence of extrahepatic disease: results from an international multi-institutional analysis. Ann Surg Oncol. 2011;18:1380–8.PubMedCrossRef Pulitanò C, Bodingbauer M, Aldrighetti L, de Jong MC, Castillo F, Schulick RD, et al. Liver resection for colorectal metastases in presence of extrahepatic disease: results from an international multi-institutional analysis. Ann Surg Oncol. 2011;18:1380–8.PubMedCrossRef
24.
Zurück zum Zitat Eto TA, Chijiiwa K, Hidaka H, Ohuchida J, Kai MH, Kondo K, et al. Sum of the longest diameters of metastatic liver tumors is a possible new prognostic factor after hepatectomy in patients with colorectal liver metastases. Hepatogastroenterology. 2006;53:909–12.PubMed Eto TA, Chijiiwa K, Hidaka H, Ohuchida J, Kai MH, Kondo K, et al. Sum of the longest diameters of metastatic liver tumors is a possible new prognostic factor after hepatectomy in patients with colorectal liver metastases. Hepatogastroenterology. 2006;53:909–12.PubMed
25.
Zurück zum Zitat House MG, Ito H, Gönen M, Fong Y, Allen PJ, DeMatteo RP, et al. Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. Am Coll Surg. 2010;210:744–55.CrossRef House MG, Ito H, Gönen M, Fong Y, Allen PJ, DeMatteo RP, et al. Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. Am Coll Surg. 2010;210:744–55.CrossRef
26.
Zurück zum Zitat Elias D, Sideris L, Pocard M, Ouellet JF, Boige V, Lasser P, et al. Results of R0 resection for colorectal liver metastases associated with extrahepatic disease. Ann Surg Oncol. 2004;11:274–80.PubMedCrossRef Elias D, Sideris L, Pocard M, Ouellet JF, Boige V, Lasser P, et al. Results of R0 resection for colorectal liver metastases associated with extrahepatic disease. Ann Surg Oncol. 2004;11:274–80.PubMedCrossRef
27.
Zurück zum Zitat Headrick JR, Miller DL, Nagorney DM, Allen MS, Deschamps C, Trastek VF, et al. Surgical treatment of hepatic and pulmonary metastases from colon cancer. Ann Thorac Surg. 2001;71:975–9.PubMedCrossRef Headrick JR, Miller DL, Nagorney DM, Allen MS, Deschamps C, Trastek VF, et al. Surgical treatment of hepatic and pulmonary metastases from colon cancer. Ann Thorac Surg. 2001;71:975–9.PubMedCrossRef
28.
Zurück zum Zitat Otto G, Düber C, Hoppe-Lotichius M, König J, Heise M, Pitton MB. Radiofrequency ablation as first-line treatment in patients with early colorectal liver metastases amenable to surgery. Ann Surg. 2010;251:796–803.PubMedCrossRef Otto G, Düber C, Hoppe-Lotichius M, König J, Heise M, Pitton MB. Radiofrequency ablation as first-line treatment in patients with early colorectal liver metastases amenable to surgery. Ann Surg. 2010;251:796–803.PubMedCrossRef
29.
Zurück zum Zitat Ruers TJ, Joosten JJ, Wiering B, Langenhoff BS, Dekker HM, Wobbes T, et al. Comparison between local ablative therapy and chemotherapy for non-resectable colorectal liver metastases: a prospective study. Ann Surg Oncol. 2007;14:1161–9.PubMedCrossRef Ruers TJ, Joosten JJ, Wiering B, Langenhoff BS, Dekker HM, Wobbes T, et al. Comparison between local ablative therapy and chemotherapy for non-resectable colorectal liver metastases: a prospective study. Ann Surg Oncol. 2007;14:1161–9.PubMedCrossRef
30.
Zurück zum Zitat Sgouros J, Cast J, Garadi KK, Belechri M, Breen DJ, Monson JR, et al. Chemotherapy plus percutaneous radiofrequency ablation in patients with inoperable colorectal liver metastases. World J Gastrointest Oncol. 2011;3:60–6.PubMedCrossRef Sgouros J, Cast J, Garadi KK, Belechri M, Breen DJ, Monson JR, et al. Chemotherapy plus percutaneous radiofrequency ablation in patients with inoperable colorectal liver metastases. World J Gastrointest Oncol. 2011;3:60–6.PubMedCrossRef
Metadaten
Titel
Radiofrequency ablation for colorectal liver metastases: prognostic factors in non-surgical candidates
verfasst von
Ayumi Hamada
Koichiro Yamakado
Atsuhiro Nakatsuka
Junji Uraki
Masataka Kashima
Haruyuki Takaki
Takashi Yamanaka
Yasuhiro Inoue
Masato Kusunoki
Kan Takeda
Publikationsdatum
01.08.2012
Verlag
Springer Japan
Erschienen in
Japanese Journal of Radiology / Ausgabe 7/2012
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-012-0089-0

Weitere Artikel der Ausgabe 7/2012

Japanese Journal of Radiology 7/2012 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.