Radiofrequency ablation of colorectal liver metastases downstaged by chemotherapy
Knudsen AR et al. - In a trial to evaluate the long-term survival of patients treated by radiofrequency ablation (RFA) for colorectal liver metastases after downstaging by systemic chemotherapy, it appears that in selected pts with colorectal liver metastases downstaged by chemotherapy, RFA is an important modality that may contribute to improved survival. Methods- In a retrospective review of prospective colorectal liver metastasis RFA database, 36 pts (20 males, 16 females; median age 67 yrs) were identified during an 8-yr period.
- All pts were initially unsuitable for local treatment, and referred to systemic chemotherapy.
- Multinodularity and/or location of tumor was the main cause of pts being unsuitable for local treatment.
- Chemotherapy mainly consisted of 5-fluorouracil and leucovorin combined with oxaliplatin or irinotecan.
- After downstaging with chemotherapy, pts were treated by RFA.
- Pts with extrahepatic disease were excluded from RFA treatment.
- Pre- and posttreatment evaluation was performed with multidetector computed tomography (MDCT) scans.
Results- Median time from diagnosis of hepatic metastases to first RFA was 10 mos.
- 158 tumors were treated with RFA.
- Median follow-up period was 27 mos.
- Estimated median survival time after diagnosis of hepatic metastasis was 39 mos, with 5-yr survival rate of 34%.
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