Open surgical is superior to percutaneous access for radiofrequency ablation of hepatic metastases.

Abstract

PURPOSE:

This study was designed to determine the best approach to radiofrequency ablation (RFA) in the liver.

METHODS:

From a total of 41 procedures, 37 patients with 47 tumors were treated with RFA for metastatic disease. Indications included colorectal cancer (n=28, 68%), neuroendocrine tumors (n=2, 5%), gynecological primaries (n=4, 10%), pancreatic/duodenal cancer (n=2, 5%), and miscellaneous entities (n=5, 12%). Mean follow-up period was 18 (median, 18) months. All ways of approach to RFA were applied: percutaneous was chosen in 17 (41.5%), laparoscopic and hand-assisted laparoscopic in 5 (12.2%), and open surgical in 19 cases (46.3%), and in 10 cases, RFA was combined with hepatic resection. The average maximum tumor size was 2.3 (range, 0.8-6) cm, and the mean number of nodules treated per patient in a single session was 1.3 (range, 1-3).

RESULTS:

Overall survival was 59.5% at 2 years, recurrence-free 2-year survival was 12.6%, local tumor recurrence rate was 34%, and overall recurrence was 75.6%. Local tumor recurrence and disease-free survival were significantly improved in the open surgically treated patients compared with the percutaneous treatment group (15.8% [n=3] vs. 58.8% [n=10] and 11.5 vs. 7.9 months, p<0.01 [chi2 test] and p<0.05 [log-rank test], respectively).

CONCLUSIONS:

Open surgical approach is superior to percutaneous access for RFA in metastatic hepatic disease.

• Authors: Robert M Eisele, Ulf Neumann, Peter Neuhaus, Guido Schumacher
• Journal: World journal of surgery (World J Surg) Vol. 33 Issue 4 Pg. 804-11 (Apr 2009) ISSN: 0364-2313 [Print] United States
• PMID: 19184639 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Catheter Ablation (methods)
• Colorectal Neoplasms (pathology)
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Laparoscopy
• Liver Neoplasms (diagnostic imaging, pathology, secondary, surgery)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (epidemiology)
• Neoplasm Staging
• Radiography
• Retrospective Studies