E Tanis1, B Nordlinger2, M Mauer3, H Sorbye4, F van Coevorden5, T Gruenberger6, P M Schlag7, C J A Punt8, J Ledermann9, T J M Ruers5. 1. EORTC Headquarters, Brussels, Belgium. Electronic address: eriktanis@gmail.com. 2. Department of Surgery, Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hopitaux de Paris, Boulogne-Billancourt, France. 3. Department of Statistics, EORTC Headquarters, Brussels, Belgium. 4. Department of Oncology, Haukeland University Hospital, Bergen, Norway. 5. Department of Surgery, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands. 6. Department of Surgery, Medical University Vienna, Vienna, Austria. 7. Department of Surgery, Robert-Roessle-Klinik, Humboldt-Universitat Berlin, Berlin, Germany. 8. Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. 9. UCL and UCL Hospitals Comprehensive Biomedical Research Centre, University College London, London, United Kingdom.
Abstract
AIM: The aim of this study is to describe local tumour control after radiofrequency ablation (RFA) and surgical resection (RES) of colorectal liver metastases (CLM) in two independent European Organisations for Research and Treatment of Cancer (EORTC) studies. BACKGROUND: Only 10-20% of patients with newly diagnosed CLM are eligible for curative RES. RFA has found a place in daily practice for unresectable CLM. There are no prospective trials comparing RFA to RES for resectable CLM. METHODS: The CLOCC trial randomised 119 patients with unresectable CLM betweenRFA (±RES)+adjuvant FOLFOX (±bevacizumab) versus FOLFOX (±bevacizumab) alone. The EPOC trial randomised 364 patients with resectable CLM between RES±perioperative FOLFOX. We describe the local control of resected patients with lesions ≤4 cm in the perioperative chemotherapy arm of the EPOC trial (N=81) and the RFA arm of the CLOCC trial (N=55). RESULTS:Local recurrence (LR) rate for RES was 7.4% per patient and 5.5% per lesion. LR rate for RFA was 14.5% per patient and 6.0% per lesion. When lesion size was limited to 30 mm, LR rate for RFA lesions was 2.9% per lesion. Non-local hepatic recurrences were more often observed in RFA patients than in RES patients, 30.9% and 22.3% respectively. Patients receiving RFA had a more advanced disease. CONCLUSIONS:LR rate after RFA for lesions with a limited size is low. The local control per lesion does not appear to differ greatly between RFA and surgical resection. This study supports the local control of RFA in patients with limited liver metastases. Future studies should evaluate in which patients RFA could be an equal alternative to liver resection.
RCT Entities:
AIM: The aim of this study is to describe local tumour control after radiofrequency ablation (RFA) and surgical resection (RES) of colorectal liver metastases (CLM) in two independent European Organisations for Research and Treatment of Cancer (EORTC) studies. BACKGROUND: Only 10-20% of patients with newly diagnosed CLM are eligible for curative RES. RFA has found a place in daily practice for unresectable CLM. There are no prospective trials comparing RFA to RES for resectable CLM. METHODS: The CLOCC trial randomised 119 patients with unresectable CLM between RFA (±RES)+adjuvant FOLFOX (±bevacizumab) versus FOLFOX (±bevacizumab) alone. The EPOC trial randomised 364 patients with resectable CLM between RES±perioperative FOLFOX. We describe the local control of resected patients with lesions ≤4 cm in the perioperative chemotherapy arm of the EPOC trial (N=81) and the RFA arm of the CLOCC trial (N=55). RESULTS: Local recurrence (LR) rate for RES was 7.4% per patient and 5.5% per lesion. LR rate for RFA was 14.5% per patient and 6.0% per lesion. When lesion size was limited to 30 mm, LR rate for RFA lesions was 2.9% per lesion. Non-local hepatic recurrences were more often observed in RFA patients than in RES patients, 30.9% and 22.3% respectively. Patients receiving RFA had a more advanced disease. CONCLUSIONS: LR rate after RFA for lesions with a limited size is low. The local control per lesion does not appear to differ greatly between RFA and surgical resection. This study supports the local control of RFA in patients with limited liver metastases. Future studies should evaluate in which patients RFA could be an equal alternative to liver resection.
Authors: Vlasios S Sotirchos; Sho Fujisawa; Efsevia Vakiani; Stephen B Solomon; Katia O Manova-Todorova; Constantinos T Sofocleous Journal: Ann Surg Oncol Date: 2019-03-04 Impact factor: 5.344
Authors: Konrad Mohnike; Steffen Wolf; Robert Damm; Max Seidensticker; Ricarda Seidensticker; Frank Fischbach; Nils Peters; Peter Hass; Günther Gademann; Maciej Pech; Jens Ricke Journal: Strahlenther Onkol Date: 2016-02-29 Impact factor: 3.621