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Vascular and Interventional Radiology |
1 From the Department of Radiology, Ospedale Generale, Busto Arsizio, Italy (L.S., T.I., M.D., L.C.); Department of Radiology, Ospedale Civile, Vimercate, Italy (T.L., F.M.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (S.N.G.); Decision Analysis and Technology Assessment Group, Department of Radiology, Massachusetts General Hospital, Zero Emerson Pl, Suite 2H, Boston, MA 02114 (E.F.H., G.S.G.); and Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass (G.S.G.). From the 1999 RSNA scientific assembly. Received October 5, 2000; revision requested November 22; revision received February 15, 2001; accepted April 3. S.N.G. supported by Radionics. Address correspondence to G.S.G.
PURPOSE: To describe the results of an ongoing radio-frequency (RF) ablation study in patients with hepatic metastases from colorectal carcinoma.
MATERIALS AND METHODS: In 117 patients, 179 metachronous colorectal carcinoma hepatic metastases (0.99.6 cm in diameter) were treated with RF ablation by using 17-gauge internally cooled electrodes. Computed tomographic follow-up was performed every 46 months. Recurrent tumors were retreated when feasible. Time to new metastases and death for each patient and time to local recurrence for individual lesions were modeled with Kaplan-Meier analysis. Modeling determined the effect of number of metastases on the time to new metastases and death and effect of tumor size on local recurrence.
RESULTS: Estimated median survival was 36 months (95% CI; 28, 52 months). Estimated 1, 2, and 3-year survival rates were 93%, 69%, and 46%, respectively. Survival was not significantly related to number of metastases treated. In 77 (66%) of 117 patients, new metastases were observed at follow-up. Estimated median time until new metastases was 12 months (95% CI; 10, 18 months). Percentages of patients with no new metastases after initial treatment at 1 and 2 years were 49% and 35%, respectively. Time to new metastases was not significantly related to number of metastases. Seventy (39%) of 179 lesions developed local recurrence after treatment. Of these, 54 were observed by 6 months and 67 by 1 year. No local recurrence was observed after 18 months. Frequency and time to local recurrence were related to lesion size (P
.001).
CONCLUSION: RF ablation is an effective method to treat hepatic metastases from colorectal carcinoma.
Index terms: Liver neoplasms, secondary, 761.33 Liver neoplasms, therapy, 761.1269 Radiofrequency (RF) ablation, 761.1269
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