Abstract
Background and aims
Radiofrequency-ablation (RFA) is increasingly used for destruction of unresectable primary and secondary liver tumors. We report our experience in the use of RFA for the management of unresectable hepatic malignancies.
Patients and methods
Between February 2000 and December 2004 we have undertaken 120 RFA procedures to ablate 426 unresectable primary or metastatic liver tumors in 88 patients. RFA was performed via laparotomy (n=68), laparoscopy (n=9) or a percutaneous approach (n=43). Primary liver cancer was treated in seven patients (8%) and metastatic liver tumors were treated in 81 patients (92%). All patients were followed to assess complications, treatment response and recurrence of malignant disease.
Results
Procedure-related complication rate was low (3.4%). During a mean follow-up of 21.2 months, 15 patients had local tumor progression (17%), 21 patients (23,9%) had new malignant disease and 27 patients (30.7%) died from intervention-unrelated complications of their malignant disease. Additional liver lesions were identified in 27 (35%) of 77 cases by intraoperative ultrasound. Thirty-six patients received simultaneous resection and RFA.
Conclusion
RFA is a safe, well-tolerated and effective treatment for patients with unresectable primary and secondary liver malignancies.
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References
Bläker H, Hofmann WJ, Theuer D, Otto HF (2001) Pathohistological findings in liver metastases. Radiologe 41:1–7
Curley SA, Izzo F, Delrio P, Ellis LM, Granchi J et al (1999) Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies—results in 123 patients. Ann Surg 230:1–8
Lehnert T, Golling M (2001) Indications and outcome of liver metastases resection. Radiologe 41(1):40–48
Scheele J, Stangl R, Altendorf-Hofmann A, Paul M (1995) Resection of colorectal liver metastases. World J Surg 19:59–71
Rustgi V (1987) Epidemiology of hepatocellular cancer. Gastroenterol Clin North Am 16:545–551
Jiao LR, Hansen PD, Havlik R, Mitry RR, Pignatelli M, Habib N (1999) Clinical short-term results of radiofrequency ablation in primary and secondary liver tumors. Am J Surg 177:303–306
Köhne CH, Lorenz M, Herrmann R (1998) Colorectal cancer liver metastasis: local treatment for a systemic disease? Ann Oncol 9:967–971
Lorenz M, Staib-Sebler G, Vetter G, Petrowsky H, Müller H-H (1999) The status of regional long-term chemotherapy in liver metastasis. Chirurg 70:141–153
Goldberg SN, Charboneau JW, Dodd GD III, Dupuy DE, Gervais DA, Gilliams AR et al (2003) Image-guided tumor ablation: proposal for standardization of terms and reporting criteria. Radiology 228:335–345
Chung MH, Wood TF, Tsioulias GJ, Rose DM, Bilchik AJ (2001) Laparoscopic radiofrequency ablation of unresectable hepatic malignancies—a phase 2 trial. Surg Endosc 15:1020–1026
Wood TF, Rose DM, Chung MH, Allegra DP, Foshag LJ, Bilchik AJ (2000) Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations and complications. Ann Surg Oncol 7(8):593–600
Scott DJ, Fleming JB, Watumull LM, Lindberg G, Tesfay ST, Jones DB (2002) The effect of hepatic inflow occlusion on laparoscopic radiofrequency ablation using simulated tumors. Surg Endosc 16:1286–1291
Scaife CL, Curley SA (2003) Complications, local recurrence, and survival rates after radiofrequency ablation for hepatic malignancies. Surg Oncol Clin N Am 12:243–255
Siperstein A, Rogers S, Hansen P, Gitomirsky A (1997) Laparoscopic thermal ablation of hepatic neuroendocrine metastases. Surgery 122:1147–1155
Mulier S, Mulier P, Ni Y, Miao Y, Dupas B, Marchal G, De Wever I, Michel L (2002) Complications of radiofrequency coagulation of liver tumors. Br J Surg 89:1206–1222
Curley SA, Marra P, Beaty K, Ellis LM, Vauthey JN, Abdalla EK, Scaife C, Raut C, Wolff R, Choi H, Loyer E, Vallone P, Fiore F, Scordino F, De Rosa V, Orlando R, Pignata S, Daniele B, Izzo F (2004) Early and late complications after radiofrequency ablation of malignant liver tumors in 608 patients. Ann Surg 239:450–458
Tanabe KK, Chioti MA (2004) Radiofrequency ablation of colon and rectal carcinoma liver metastases. In: Ellis LM, Curley SA, Tanabe KK. Radiofrequency ablation for cancer—current indications, techniques, and outcomes, 1st edn. Springer, Berlin Heidelberg New York, pp 31–46
Solbiati L, Livraghi T, Goldberg SN, Ierace T (2001) Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 221:159–166
Siperstein AE, Rogers SJ, Machi J, Goldstein R, Sielaff T, Rosato E (2002) Long-term follow-up of patients undergoing radiofrequency thermal ablation of primary metastatic liver tumors: a multi-center study. Vorgestellt auf dem ACS 88th Annual Clinical Congress, San Fransisco, CA, USA 9
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Hildebrand, P., Kleemann, M., Roblick, U.J. et al. Radiofrequency-ablation of unresectable primary and secondary liver tumors: results in 88 patients. Langenbecks Arch Surg 391, 118–123 (2006). https://doi.org/10.1007/s00423-006-0024-x
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DOI: https://doi.org/10.1007/s00423-006-0024-x