Patterns of recurrence after ablation of colorectal cancer liver metastases Journal Article
| Authors: | Kingham, T. P.; Tanoue, M.; Eaton, A.; Rocha, F. G.; Do, R.; Allen, P.; De Matteo, R. P.; D'Angelica, M.; Fong, Y.; Jarnagin, W. R. |
| Article Title: | 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. © Society of Surgical Oncology 2011. |
| Keywords: | adult; cancer chemotherapy; treatment outcome; aged; aged, 80 and over; middle aged; survival rate; major clinical study; overall survival; mortality; cancer recurrence; bevacizumab; cisplatin; fluorouracil; liver neoplasms; adjuvant therapy; postoperative care; neoadjuvant therapy; colorectal cancer; metastasis; neoplasm recurrence, local; tumor volume; pathology; cetuximab; irinotecan; colorectal neoplasms; medical instrumentation; liver metastasis; proportional hazards model; intraoperative period; colorectal tumor; tumor recurrence; liver tumor; liver resection; hepatectomy; multivariate analysis; preoperative treatment; kaplan meier method; oxaliplatin; radiofrequency ablation; floxuridine; univariate analysis; catheter ablation; hepatic artery; cryotherapy; microwave radiation; infusion pump; adjuvant chemoradiotherapy; chemoradiotherapy, adjuvant |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 19 |
| Issue: | 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2012-03-01 |
| Start Page: | 834 |
| End Page: | 841 |
| Language: | English |
| DOI: | 10.1245/s10434-011-2048-x |
| PROVIDER: | scopus |
| PUBMED: | 21879262 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 July 2012" - "CODEN: ASONF" - "Source: Scopus" |
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