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Vascular and Interventional Radiology |
1 From the Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. Received June 12, 2002; revision requested August 14; final revision received April 29, 2003; accepted June 23. Address correspondence to T.J.V. (e-mail: t.vogl@em.uni-frankfurt.de).
PURPOSE: To evaluate the local tumor control and survival data for magnetic resonance (MR) imaging–guided laser-induced interstitial thermotherapy (LITT) of colorectal liver metastases.
MATERIALS AND METHODS: MR imaging–guided LITT was performed in 603 patients (mean age, 61.2 years) with 1,801 liver metastases of colorectal cancer. Survival rates were calculated by means of the Kaplan-Meier method. Local tumor control and tumor volume were evaluated with nonenhanced and contrast material–enhanced MR imaging. Indications for the procedure were defined for patients with five or fewer metastases, none of which were larger than 5 cm in diameter. The indications included recurrent liver metastases after partial liver resection in 37.6% of study patients, metastases in both liver lobes in 32.5%, locally nonresectable lesions in 11.3%, general contraindications for surgery in 4.6%, and refusal to undergo surgical resection in 13.9%.
RESULTS: Local recurrence rate at 6-month follow-up was 1.9% (nine of 474) for metastases up to 2 cm in diameter, 2.4% (13 of 539) for metastases 2.1–3.0 cm in diameter, 1.2% (four of 327) for metastases 3.1–4.0 cm in diameter, and 4.4% (13 of 294) for metastases larger than 4 cm in diameter. The mean survival rate for all treated patients, with calculation started on the date of diagnosis of the metastases (which were treated with LITT) was 4.4 years (95% CI: 4.0, 4.8) (1-year survival, 94%; 2-year survival, 77%; 3-year survival, 56%; 5-year survival, 37%). Median survival was 3.5 years (95% CI: 3.0, 3.9). Mean survival after the first LITT treatment was 3.8 years (95% CI: 3.4, 4.2). Median survival was 2.9 years (95% CI: 2.4, 3.3).
CONCLUSION: MR imaging–guided LITT yields high local tumor control and survival rates in well-selected patients with limited liver metastases of colorectal carcinoma.
© RSNA, 2003
Index terms: Lasers, interstitial therapy, 76.1284 • Liver, interventional procedures, 76.1284 • Liver neoplasms, metastases, 76.33 • Liver neoplasms, MR, 76.121411, 76.121412, 76.12143 • Liver neoplasms, therapy, 76.1284 • Magnetic resonance (MR), guidance, 76.121411
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