B G Fosh1, J G Finch, M Lea, C Black, S Wong, S Wemyss-Holden, G J Maddern. 1. University of Adelaide Department of Surgery and Department of Radiology, The Queen Elizabeth Hospital, Woodville Road, Woodville 5011, Adelaide, South Australia, Australia.
Abstract
BACKGROUND: Patients with hepatic metastases are potentially curable if all the diseased tissue can be resected. Unfortunately, only 10-20 per cent of patients are suitable for curative resection. Electrolysis is a novel non-thermal method of tissue ablation. When used in conjunction with surgery it may increase the number of resectable liver tumours with curative treatment. METHODS: All patients had been deemed inoperable using currently accepted criteria. Nine patients with hepatic deposits from colorectal carcinoma underwent combined surgical resection and electrolytic ablation of metastases. RESULTS: The treatment was associated with minimal morbidity. Within the electrolytically treated area seven patients had no radiological evidence of recurrence at a median follow-up of 9 (range 6-43) months; local recurrence was detected in two patients. Six of the nine patients had metastases elsewhere in the liver with four having extrahepatic metastases. Three patients remain tumour free. Three patients died. The median survival was 17 (range 9-24) months from the time of treatment. DISCUSSION: Electrolysis with resection may confer a disease-free and overall survival benefit. The small size of this initial study precludes statistical analysis, but preliminary results are encouraging.
BACKGROUND:Patients with hepatic metastases are potentially curable if all the diseased tissue can be resected. Unfortunately, only 10-20 per cent of patients are suitable for curative resection. Electrolysis is a novel non-thermal method of tissue ablation. When used in conjunction with surgery it may increase the number of resectable liver tumours with curative treatment. METHODS: All patients had been deemed inoperable using currently accepted criteria. Nine patients with hepatic deposits from colorectal carcinoma underwent combined surgical resection and electrolytic ablation of metastases. RESULTS: The treatment was associated with minimal morbidity. Within the electrolytically treated area seven patients had no radiological evidence of recurrence at a median follow-up of 9 (range 6-43) months; local recurrence was detected in two patients. Six of the nine patients had metastases elsewhere in the liver with four having extrahepatic metastases. Three patients remain tumour free. Three patients died. The median survival was 17 (range 9-24) months from the time of treatment. DISCUSSION: Electrolysis with resection may confer a disease-free and overall survival benefit. The small size of this initial study precludes statistical analysis, but preliminary results are encouraging.
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