BACKGROUND: Radiofrequency ablation (RFA) continues to evolve, improving the potentials of this technique. It is now a widely used procedure in the treatment of patients with unresectable colorectal liver metastases, increasing the number of potentially curable patients. PURPOSE: To evaluate the long-term survival of patients treated by RFA for colorectal liver metastases after downstaging by systemic chemotherapy. MATERIAL AND METHODS: In a retrospective review of our prospective colorectal liver metastasis RFA database, 36 patients (20 males, 16 females; median age 67 years) were identified during an 8-year period (1999-2007). All patients were initially unsuitable for local treatment, and referred to systemic chemotherapy by our multidisciplinary team. Multinodularity and/or location of tumor was the main cause of patients being unsuitable for local treatment. Chemotherapy mainly consisted of 5-fluorouracil and leucovorin combined with oxaliplatin or irinotecan. After downstaging with chemotherapy, patients were treated by RFA. Patients with extrahepatic disease were excluded from RFA treatment. Pre- and posttreatment evaluation was performed with multidetector computed tomography (MDCT) scans. RESULTS: The median time from diagnosis of hepatic metastases to first RFA was 10 months. A total of 158 tumors were treated with RFA during the study period. Median follow-up period was 27 months. The estimated median survival time after diagnosis of hepatic metastasis was 39 months, with a 5-year survival rate of 34%. CONCLUSION: In selected patients with colorectal liver metastases downstaged by chemotherapy, RFA is an important modality that may contribute to improved survival. Furthermore, all patients responding to systemic chemotherapy should be re-evaluated by a multidisciplinary team.
BACKGROUND: Radiofrequency ablation (RFA) continues to evolve, improving the potentials of this technique. It is now a widely used procedure in the treatment of patients with unresectable colorectal liver metastases, increasing the number of potentially curable patients. PURPOSE: To evaluate the long-term survival of patients treated by RFA for colorectal liver metastases after downstaging by systemic chemotherapy. MATERIAL AND METHODS: In a retrospective review of our prospective colorectal liver metastasis RFA database, 36 patients (20 males, 16 females; median age 67 years) were identified during an 8-year period (1999-2007). All patients were initially unsuitable for local treatment, and referred to systemic chemotherapy by our multidisciplinary team. Multinodularity and/or location of tumor was the main cause of patients being unsuitable for local treatment. Chemotherapy mainly consisted of 5-fluorouracil and leucovorin combined with oxaliplatin or irinotecan. After downstaging with chemotherapy, patients were treated by RFA. Patients with extrahepatic disease were excluded from RFA treatment. Pre- and posttreatment evaluation was performed with multidetector computed tomography (MDCT) scans. RESULTS: The median time from diagnosis of hepatic metastases to first RFA was 10 months. A total of 158 tumors were treated with RFA during the study period. Median follow-up period was 27 months. The estimated median survival time after diagnosis of hepatic metastasis was 39 months, with a 5-year survival rate of 34%. CONCLUSION: In selected patients with colorectal liver metastases downstaged by chemotherapy, RFA is an important modality that may contribute to improved survival. Furthermore, all patients responding to systemic chemotherapy should be re-evaluated by a multidisciplinary team.
Authors: Tatjana Gruber-Rouh; Christian Marko; Axel Thalhammer; Nour-Eldin Nour-Eldin; Marcel Langenbach; Martin Beeres; Nagy N Naguib; Stephan Zangos; Thomas J Vogl Journal: Br J Radiol Date: 2016-05-26 Impact factor: 3.039
Authors: Jeanett Klubien; Andreas P Kohl; Christian P Nolsøe; Jacob Rosenberg; Hans-Christian Pommergaard Journal: Australas J Ultrasound Med Date: 2018-04-02
Authors: Thomas J Vogl; Parviz Farshid; Nagy N N Naguib; Abbas Darvishi; Babak Bazrafshan; Emmanuel Mbalisike; Thorsten Burkhard; Stephan Zangos Journal: Radiol Med Date: 2014-06-04 Impact factor: 3.469
Authors: Karin Nielsen; Hester J Scheffer; José H Volders; Maurice J D L van der Vorst; Aukje A J M van Tilborg; Emile Fi Comans; E S M de Lange-de Klerk; Colin Sietses; Sybren Meijer; Martijn R Meijerink; M Petrousjka van den Tol Journal: World J Surg Date: 2016-08 Impact factor: 3.352
Authors: Klaas M Govaert; Charlotte S van Kessel; Martijn Lolkema; Theo J M Ruers; Inne H M Borel Rinkes Journal: Curr Colorectal Cancer Rep Date: 2012-03-17
Authors: Alice Gillams; Nahum Goldberg; Muneeb Ahmed; Reto Bale; David Breen; Matthew Callstrom; Min Hua Chen; Byung Ihn Choi; Thierry de Baere; Damian Dupuy; Afshin Gangi; Debra Gervais; Thomas Helmberger; Ernst-Michael Jung; Fred Lee; Riccardo Lencioni; Ping Liang; Tito Livraghi; David Lu; Franca Meloni; Philippe Pereira; Fabio Piscaglia; Hyunchul Rhim; Riad Salem; Constantinos Sofocleous; Stephen B Solomon; Michael Soulen; Masatoshi Tanaka; Thomas Vogl; Brad Wood; Luigi Solbiati Journal: Eur Radiol Date: 2015-05-22 Impact factor: 5.315