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Percutaneous stereotactic radiofrequency ablation of colorectal liver metastases

  • Oncology
  • Published:
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Abstract

Objectives

To evaluate the outcome of patients with colorectal liver metastasis (CRLM) treated with stereotactic radiofrequency ablation (SRFA).

Methods

Following IRB approval, a retrospective evaluation of 98 SRFA treatment sessions of 189 CRLMs in 63 consecutive patients was performed. Local recurrence rate (LR), overall survival (OS) and disease-free survival (DFS) were analysed.

Results

LR was identified in 16% of the tumours (31/189), with no significant differences (P = 0.635) when comparing tumour sizes <3 cm (17.7%), 3–5 cm (11.1%) and >5 cm (17.4%). The median OS from SRFA treatment was 33.2 months after a mean follow-up of 25 months (range 2–66); the corresponding 1-, 3- and 5- year survival rates were 87%, 44% and 27%. The median OS was significantly different when comparing unresectable and resectable patients (27 vs. 58 months, P = 0.002) with OS rates of 92%, 66% and 48% at 1, 3 and 5 years in resectable patients. Tumour size did not affect OS and DFS.

Conclusion

Due to the favourable outcome, SRFA challenges resection as first-line local treatment of patients with CRLM. As long as randomised studies are pending, we recommend entering an individual decision-making process with every patient.

Key Points

• Large colorectal liver metastases can be effectively treated by stereotactic radiofrequency ablation (SRFA).

• Using SRFA the overall survival is not affected by tumour size.

• SRFA achieves similar overall and disease-free survival rates as surgical resection.

• SRFA challenges surgical resection as the first-line treatment for colorectal liver metastases.

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Acknowledgments

The authors thank Michael Vogele, MD for the technical support and the radiation technicians Thomas Lang, Martin Knoflach, Christoph Hinterleithner, Julia Mahlknecht, Yvonne Schlesinger, Martin Fasser and Florian Schanda for their assistance.

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Authors and Affiliations

  1. Department of Microinvasive Therapy (SIP), Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Reto Bale, Gerlig Widmann, Peter Schullian & Marion Haidu

  2. Department of Internal Medicine, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Georg Pall

  3. Department of Surgery, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria

    Alexander Klaus, Helmut Weiss, Matthias Biebl & Raimund Margreiter

Authors
  1. Reto Bale
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  2. Gerlig Widmann
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  3. Peter Schullian
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  4. Marion Haidu
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  5. Georg Pall
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  6. Alexander Klaus
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  9. Raimund Margreiter
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Correspondence to Reto Bale.

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Bale, R., Widmann, G., Schullian, P. et al. Percutaneous stereotactic radiofrequency ablation of colorectal liver metastases. Eur Radiol 22, 930–937 (2012). https://doi.org/10.1007/s00330-011-2314-0

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  • DOI: https://doi.org/10.1007/s00330-011-2314-0

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