Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation

Eur Radiol. 2009 May;19(5):1206-13. doi: 10.1007/s00330-008-1258-5. Epub 2009 Jan 10.

Abstract

There is little published long-term survival data for patients with colorectal liver metastases treated with radiofrequency ablation (RFA). We present a multivariate analysis of 5-year survival in 309 patients (198 male, aged 64 (24-92)) treated at 617 sessions. Our standard protocol used internally cooled electrodes introduced percutaneously under combined US and CT guidance/monitoring. The number and size of liver metastases, the presence and location of extrahepatic disease, primary resection, clinical, chemotherapy and follow-up data were recorded. Data analysis was performed using SPSS v.10. On multivariate analysis, significant survival factors were the presence of extrahepatic disease (p < 0.001) and liver tumour volume (p = 0.001). For 123 patients with five or less metastases of 5 cm or less maximum diameter and no extrahepatic disease median survival was 46 and 36 months from liver metastasis diagnosis and ablation, respectively; corresponding 3- and 5-year survival rates were 63%, 34% and 49%, 24%. Sixty-nine patients had three or less tumours of below 3.5 cm in diameter and their 5-year survival from ablation was 33%. There were 23/617(3.7%) local complications requiring intervention. Five-year survival of 24-33% post ablation in selected patients is superior to any published chemotherapy data and approaches the results of liver resection.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheter Ablation
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / radiotherapy*
  • Colorectal Neoplasms / secondary*
  • Disease-Free Survival
  • Female
  • Hot Temperature
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Survival Rate
  • Treatment Outcome