Patterns of recurrence after ablation of colorectal cancer liver metastases.

Abstract

PURPOSE:

To determine the local recurrence rate and factors associated with recurrence after intraoperative ablation of colorectal cancer liver metastases.

METHODS:

A retrospective analysis of a prospectively maintained database was performed for patients who underwent ablation of a hepatic colorectal cancer metastasis in the operating room from April 1996 to March 2010. Kaplan-Meier survival curves and Cox models were used to determine recurrence rates and assess significance.

RESULTS:

Ablation was performed in 10% (n = 158 patients) of all cases during the study period. Seventy-eight percent were performed in conjunction with a liver resection. Of the 315 tumors ablated, most tumors were ≤ 1 cm in maximum diameter (53%). Radiofrequency ablation was used to treat most of the tumors (70%). Thirty-six tumors (11%) had local recurrence as part of their recurrence pattern. Disease recurred in the liver or systemically after 212 tumors (67%) were ablated. On univariate analysis, tumor size greater than 1 cm was associated with a significantly increased risk of local recurrence (hazard ratio 2.3, 95% confidence interval 1.2-4.5, P = 0.013). The 2 year ablation zone recurrence-free survival was 92% for tumors ≤ 1 cm compared to 81% for tumors >1 cm. On multivariate analysis, tumor size of >1 cm, lack of postoperative chemotherapy, and use of cryotherapy were significantly associated with a higher local recurrence rate.

CONCLUSIONS:

Intraoperative ablation appears to be highly effective treatment for hepatic colorectal tumors ≤ 1 cm.

• Authors: T Peter Kingham, Michael Tanoue, Anne Eaton, Flavio G Rocha, Richard Do, Peter Allen, Ronald P De Matteo, Michael D'Angelica, Yuman Fong, William R Jarnagin
• Journal: Annals of surgical oncology (Ann Surg Oncol) Vol. 19 Issue 3 Pg. 834-41 (Mar 2012) ISSN: 1534-4681 [Electronic] United States
• PMID: 21879262 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Catheter Ablation
• Chemoradiotherapy, Adjuvant
• Colorectal Neoplasms (pathology)
• Female
• Hepatectomy
• Humans
• Liver Neoplasms (mortality, secondary, surgery)
• Male
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm Recurrence, Local
• Survival Rate