S Ohhigashi1, F Watanabe. 1. Department of Surgery, St. Luke's International Hospital, 9-1 Akashicho Chuoku, Tokyo 104-8560, Japan. ohsei@luke.or.jp
Abstract
BACKGROUND: We evaluated radiofrequency ablation (RFA) as a new local treatment for pelvic recurrence of rectal carcinoma. METHODS: Fourteen lesions in 10 patients were treated by RFA. Four patients with a solitary recurrent tumor were treated curatively, while 10 lesions in the remaining 6 patients with distant metastases were treated palliatively mainly to control pain. RFA was performed under CT guidance and epidural anesthesia. It was carried out by a single insertion for tumors 3 cm or less in diameter or by multiple insertions for tumors greater than 3 cm. Ablation effectiveness was evaluated by magnetic resonance imaging. For palliative cases, severity of pain was assessed using a visual analogue scale. RESULTS: Needle placement and ablation were accomplished in all 14 lesions. Complications following RFA consisted of 2 cases of abscess formation, 2 cases of neuralgia and one case of bleeding. To obtain complete necrosis, the tumor should be under 4 cm in diameter and not involve any major iliac vessels. Three of 4 patients treated curatively met these conditions. Among these 4 patients, only one recurrence was observed after RFA (follow-up, 6-36 months). Five of 6 patients treated palliatively had tumours greater than 4 cm in diameter or involving iliac vessels. In none of the patients did we achieve complete necrosis and satisfactory analgesia. CONCLUSION: Although certain conditions must be met, RFA is a feasible and effective treatment, and it should be considered as one of the treatment options for pelvic recurrence of rectal carcinoma.
BACKGROUND: We evaluated radiofrequency ablation (RFA) as a new local treatment for pelvic recurrence of rectal carcinoma. METHODS: Fourteen lesions in 10 patients were treated by RFA. Four patients with a solitary recurrent tumor were treated curatively, while 10 lesions in the remaining 6 patients with distant metastases were treated palliatively mainly to control pain. RFA was performed under CT guidance and epidural anesthesia. It was carried out by a single insertion for tumors 3 cm or less in diameter or by multiple insertions for tumors greater than 3 cm. Ablation effectiveness was evaluated by magnetic resonance imaging. For palliative cases, severity of pain was assessed using a visual analogue scale. RESULTS: Needle placement and ablation were accomplished in all 14 lesions. Complications following RFA consisted of 2 cases of abscess formation, 2 cases of neuralgia and one case of bleeding. To obtain complete necrosis, the tumor should be under 4 cm in diameter and not involve any major iliac vessels. Three of 4 patients treated curatively met these conditions. Among these 4 patients, only one recurrence was observed after RFA (follow-up, 6-36 months). Five of 6 patients treated palliatively had tumours greater than 4 cm in diameter or involving iliac vessels. In none of the patients did we achieve complete necrosis and satisfactory analgesia. CONCLUSION: Although certain conditions must be met, RFA is a feasible and effective treatment, and it should be considered as one of the treatment options for pelvic recurrence of rectal carcinoma.
Authors: L G P H Vroomen; H J Scheffer; M C A M Melenhorst; N van Grieken; M P van den Tol; M R Meijerink Journal: Cardiovasc Intervent Radiol Date: 2017-05-03 Impact factor: 2.740