Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Radiofrequency Ablation for Treating Liver Metastases from a Non-Colorectal Origin

  • Yun, Bo-La (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Jeong-Min (Department of Radiology, Seoul National University Hospital) ;
  • Baek, Ji-Hyun (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Se-Hyung (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Jae-Young (Department of Radiology, Seoul National University Hospital) ;
  • Han, Joon-Koo (Department of Radiology, Seoul National University Hospital) ;
  • Choi, Byung-Ihn (Department of Radiology, Seoul National University Hospital)
  • Published : 2011.10.01
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Abstract

Objective: We wanted to assess the safety and efficacy of performing radiofrequency ablation (RFA) in patients with noncolorectal liver metastases. Materials and Methods: In this retrospective study, 25 patients with 40 hepatic metastases (M:F = 17:8; mean age, 57 years; tumor size, 0.5-5.0 cm) from a non-colorectal origin (stomach, biliary, breast, pancreas, kidney and skin) were treated with RFA. The RFA procedures were performed using either an internally cooled electrode or a clustered electrode under ultrasound or CT guidance. Contrast-enhanced CT scans were obtained immediately after RFA and follow-up CT scans were performed within three months after ablation and subsequently at least every six months. The intrahepatic diseasefree interval was estimated and the overall survival from the time of the initial RFA was analyzed using the Kaplan-Meier method. Results: No intraprocedural deaths occurred, but four major complications developed, including abscesses (n = 3) and pneumothorax (n = 1). Technical effectiveness was determined on the initial follow-up images. During the follow-up period (range, 5.9-68.6 months; median time, 18.8 months) for 37 tumors in 22 patients where technical effectiveness was achieved, 12 lesions (32%, 12 of 37) showed local tumor progression and new intrahepatic metastases occurred in 13 patients (59%, 13 of 22). The median intrahepatic disease-free interval was 10.1 months. The 1-year, 3-year and 5-year overall survival rates after RFA were 86%, 39% and 19%, respectively. Conclusion: RFA showed intermediate therapeutic effectiveness for the treatment of non-colorectal origin liver metastases.

Keywords

References

  1. Fong Y, Sun RL, Jarnagin W, Blumgart LH. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg 1999;229:790-799; discussion 799-800 https://doi.org/10.1097/00000658-199906000-00005
  2. Llovet JM, Fuster J, Bruix J. Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 1999;30:1434-1440 https://doi.org/10.1002/hep.510300629
  3. Poon RT, Fan ST, Lo CM, Liu CL, Wong J. Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg 2002;235:373-382 https://doi.org/10.1097/00000658-200203000-00009
  4. Lencioni R, Cioni D, Crocetti L, Franchini C, Pina CD, Lera J, et al. Early-stage hepatocellular carcinoma in patients with cirrhosis: long-term results of percutaneous image-guided radiofrequency ablation. Radiology 2005;234:961-967 https://doi.org/10.1148/radiol.2343040350
  5. Choi D, Lim HK, Rhim H, Kim YS, Lee WJ, Paik SW, et al. Percutaneous radiofrequency ablation for early-stage hepatocellular carcinoma as a first-line treatment: long-term results and prognostic factors in a large single-institution series. Eur Radiol 2007;17:684-692 https://doi.org/10.1007/s00330-006-0461-5
  6. Fukuda S, Itamoto T, Nakahara H, Kohashi T, Ohdan H, Hino H, et al. Clinicopathologic features and prognostic factors of resected solitary small-sized hepatocellular carcinoma. Hepatogastroenterology 2005;52:1163-1167
  7. Solbiati L, Livraghi T, Goldberg SN, Ierace T, Meloni F, Dellanoce M, et al. Percutaneous radio-frequency ablation of hepatic metastases from colorectal cancer: long-term results in 117 patients. Radiology 2001;221:159-166 https://doi.org/10.1148/radiol.2211001624
  8. Iannitti DA, Dupuy DE, Mayo-Smith WW, Murphy B. Hepatic radiofrequency ablation. Arch Surg 2002;137:422-426; discussion 427 https://doi.org/10.1001/archsurg.137.4.422
  9. Machi J, Oishi AJ, Sumida K, Sakamoto K, Furumoto NL, Oishi RH, et al. Long-term outcome of radiofrequency ablation for unresectable liver metastases from colorectal cancer: evaluation of prognostic factors and effectiveness in firstand second-line management. Cancer J 2006;12:318-326 https://doi.org/10.1097/00130404-200607000-00011
  10. Abitabile P, Hartl U, Lange J, Maurer CA. Radiofrequency ablation permits an effective treatment for colorectal liver metastasis. Eur J Surg Oncol 2007;33:67-71 https://doi.org/10.1016/j.ejso.2006.10.040
  11. Sorensen SM, Mortensen FV, Nielsen DT. Radiofrequency ablation of colorectal liver metastases: long-term survival. Acta Radiol 2007;48:253-258 https://doi.org/10.1080/02841850601161539
  12. Gillams AR, Lees WR. Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation. Eur Radiol 2009;19:1206-1213 https://doi.org/10.1007/s00330-008-1258-5
  13. Hur H, Ko YT, Min BS, Kim KS, Choi JS, Sohn SK, et al. Comparative study of resection and radiofrequency ablation in the treatment of solitary colorectal liver metastases. Am J Surg 2009;197:728-736 https://doi.org/10.1016/j.amjsurg.2008.04.013
  14. Oshowo A, Gillams A, Harrison E, Lees WR, Taylor I. Comparison of resection and radiofrequency ablation for treatment of solitary colorectal liver metastases. Br J Surg 2003;90:1240-1243 https://doi.org/10.1002/bjs.4264
  15. Veltri A, Sacchetto P, Tosetti I, Pagano E, Fava C, Gandini G. Radiofrequency ablation of colorectal liver metastases: small size favorably predicts technique effectiveness and survival. Cardiovasc Intervent Radiol 2008;31:948-956 https://doi.org/10.1007/s00270-008-9362-0
  16. Ahn YO. Cancer in Korea: present features. Jpn J Clin Oncol 2002;32 Suppl:S32-36
  17. Shin HR. Global activity of cancer registries and cancer control and cancer incidence statistics in Korea. J Prev Med Public Health 2008;41:84-91 https://doi.org/10.3961/jpmph.2008.41.2.84
  18. Khan SA, Taylor-Robinson SD, Toledano MB, Beck A, Elliott P, Thomas HC. Changing international trends in mortality rates for liver, biliary and pancreatic tumours. J Hepatol 2002;37:806-813 https://doi.org/10.1016/S0168-8278(02)00297-0
  19. Kim HO, Hwang SI, Hong HP, Yoo CH. Radiofrequency ablation for metachronous hepatic metastases from gastric cancer. Surg Laparosc Endosc Percutan Tech 2009;19:208-212 https://doi.org/10.1097/SLE.0b013e3181a033d7
  20. An JY, Kim JY, Choi MG, Noh JH, Choi D, Sohn TS, et al. Radiofrequency ablation for hepatic metastasis from gastric adenocarcinoma. Yonsei Med J 2008;49:1046-1051 https://doi.org/10.3349/ymj.2008.49.6.1046
  21. Carditello A, Scisca C, Stilo F, Parisi A, Basile M. The possible role of radiofrequency as complementary treatment of locally advanced gastric cancer. Ann Ital Chir 2005;76:39-41
  22. Kim JH, Won HJ, Shin YM, Kim PN, Lee SG, Hwang S. Radiofrequency ablation for recurrent intrahepatic cholangiocarcinoma after curative resection. Eur J Radiol 2010 [Epub ahead of print]
  23. Carrafiello G, Lagana D, Cotta E, Mangini M, Fontana F, Bandiera F, et al. Radiofrequency ablation of intrahepatic cholangiocarcinoma: preliminary experience. Cardiovasc Intervent Radiol 2010;33:835-839 https://doi.org/10.1007/s00270-010-9849-3
  24. Sofocleous CT, Nascimento RG, Gonen M, Theodoulou M, Covey AM, Brody LA, et al. Radiofrequency ablation in the management of liver metastases from breast cancer. AJR Am J Roentgenol 2007;189:883-889 https://doi.org/10.2214/AJR.07.2198
  25. Livraghi T, Goldberg SN, Solbiati L, Meloni F, Ierace T, Gazelle GS. Percutaneous radio-frequency ablation of liver metastases from breast cancer: initial experience in 24 patients. Radiology 2001;220:145-149
  26. Lawes D, Chopada A, Gillams A, Lees W, Taylor I. Radiofrequency ablation (RFA) as a cytoreductive strategy for hepatic metastasis from breast cancer. Ann R Coll Surg Engl 2006;88:639-642 https://doi.org/10.1308/003588406X149129
  27. Gunabushanam G, Sharma S, Thulkar S, Srivastava DN, Rath GK, Julka PK, et al. Radiofrequency ablation of liver metastases from breast cancer: results in 14 patients. J Vasc Interv Radiol 2007;18:67-72 https://doi.org/10.1016/j.jvir.2006.10.014
  28. Rath GK, Julka PK, Thulkar S, Sharma DN, Bahl A, Bhatnagar S. Radiofrequency ablation of hepatic metastasis: results of treatment in forty patients. J Cancer Res Ther 2008;4:14-17 https://doi.org/10.4103/0973-1482.39599
  29. Penka I, Kaplan Z, Sefr R, Sirotek L, Eber Z, Ondrak M. Use of radiofrequency ablation in the treatment of malignant liver lesions. Hepatogastroenterology 2008;55:562-567
  30. Mazzaglia PJ, Berber E, Milas M, Siperstein AE. Laparoscopic radiofrequency ablation of neuroendocrine liver metastases: a 10-year experience evaluating predictors of survival. Surgery 2007;142:10-19 https://doi.org/10.1016/j.surg.2007.01.036
  31. Fan WJ, Wu PH, Zhang L, Huang JH, Zhang FJ, Gu YK, et al. Radiofrequency ablation as a treatment for hilar cholangiocarcinoma. World J Gastroenterol 2008;14:4540-4545 https://doi.org/10.3748/wjg.14.4540
  32. Gervais DA, Arellano RS, Mueller PR. Percutaneous radiofrequency ablation of ovarian cancer metastasis to the liver: indications, outcomes, and role in patient management. AJR Am J Roentgenol 2006;187:746-750 https://doi.org/10.2214/AJR.05.1106
  33. Yokoyama T, Egami K, Miyamoto M, Watanabe H, Hasegawa H, Iida S, et al. Percutaneous and laparoscopic approaches of radiofrequency ablation treatment for liver cancer. J Hepatobiliary Pancreat Surg 2003;10:425-427 https://doi.org/10.1007/s00534-002-0830-7
  34. Kim SW, Rhim H, Park M, Kim H, Kim YS, Choi D, et al. Percutaneous radiofrequency ablation of hepatocellular carcinomas adjacent to the gallbladder with internally cooled electrodes: assessment of safety and therapeutic efficacy. Korean J Radiol 2009;10:366-376 https://doi.org/10.3348/kjr.2009.10.4.366
  35. Kang TW, Rhim H, Kim EY, Kim YS, Choi D, Lee WJ, et al. Percutaneous radiofrequency ablation for the hepatocellular carcinoma abutting the diaphragm: assessment of safety and therapeutic efficacy. Korean J Radiol 2009;10:34-42 https://doi.org/10.3348/kjr.2009.10.1.34
  36. Yoo CH, Noh SH, Shin DW, Choi SH, Min JS. Recurrence following curative resection for gastric carcinoma. Br J Surg 2000;87:236-242 https://doi.org/10.1046/j.1365-2168.2000.01360.x
  37. Kwok CM, Wu CW, Lo SS, Shen KH, Hsieh MC, Lui WY. Survival of gastric cancer with concomitant liver metastases. Hepatogastroenterology 2004;51:1527-1530
  38. Okano K, Maeba T, Ishimura K, Karasawa Y, Goda F, Wakabayashi H, et al. Hepatic resection for metastatic tumors from gastric cancer. Ann Surg 2002;235:86-91 https://doi.org/10.1097/00000658-200201000-00011
  39. Sakamoto Y, Ohyama S, Yamamoto J, Yamada K, Seki M, Ohta K, et al. Surgical resection of liver metastases of gastric cancer: an analysis of a 17-year experience with 22 patients. Surgery 2003;133:507-511 https://doi.org/10.1067/msy.2003.147
  40. Koga R, Yamamoto J, Ohyama S, Saiura A, Seki M, Seto Y, et al. Liver resection for metastatic gastric cancer: experience with 42 patients including eight long-term survivors. Jpn J Clin Oncol 2007;37:836-842 https://doi.org/10.1093/jjco/hym113
  41. D'Angelica M, Gonen M, Brennan MF, Turnbull AD, Bains M, Karpeh MS. Patterns of initial recurrence in completely resected gastric adenocarcinoma. Ann Surg 2004;240:808-816 https://doi.org/10.1097/01.sla.0000143245.28656.15
  42. Yamakado K, Nakatsuka A, Takaki H, Mori Y, Tonouchi H, Kusunoki M, et al. Prospective study of arterial infusion chemotherapy followed by radiofrequency ablation for the treatment of liver metastasis of gastric cancer. J Vasc Interv Radiol 2005;16:1747-1751 https://doi.org/10.1097/01.RVI.0000188738.84911.3B
  43. Hasegawa S, Ikai I, Fujii H, Hatano E, Shimahara Y. Surgical resection of hilar cholangiocarcinoma: analysis of survival and postoperative complications. World J Surg 2007;31:1256-1263
  44. Valverde A, Bonhomme N, Farges O, Sauvanet A, Flejou JF, Belghiti J. Resection of intrahepatic cholangiocarcinoma: a Western experience. J Hepatobiliary Pancreat Surg 1999;6:122-127 https://doi.org/10.1007/s005340050094
  45. El Rassi ZE, Partensky C, Scoazec JY, Henry L, Lombard-Bohas C, Maddern G. Peripheral cholangiocarcinoma: presentation, diagnosis, pathology and management. Eur J Surg Oncol 1999;25:375-380 https://doi.org/10.1053/ejso.1999.0660
  46. McMasters KM, Tuttle TM, Leach SD, Rich T, Cleary KR, Evans DB, et al. Neoadjuvant chemoradiation for extrahepatic cholangiocarcinoma. Am J Surg 1997;174:605-608; discussion 608-609 https://doi.org/10.1016/S0002-9610(97)00203-1
  47. Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet 2005;366:1303-1314 https://doi.org/10.1016/S0140-6736(05)67530-7
  48. Vlastos G, Smith DL, Singletary SE, Mirza NQ, Tuttle TM, Popat RJ, et al. Long-term survival after an aggressive surgical approach in patients with breast cancer hepatic metastases. Ann Surg Oncol 2004;11:869-874 https://doi.org/10.1245/ASO.2004.01.007

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