Margin size is an independent predictor of local tumor progression after ablation of colon cancer liver metastases Journal Article

Authors: Wang, X.; Sofocleous, C. T.; Erinjeri, J. P.; Petre, E. N.; Gonen, M.; Do, K. G.; Brown, K. T.; Covey, A. M.; Brody, L. A.; Alago, W.; Thornton, R. H.; Kemeny, N. E.; Solomon, S. B.
Article Title: Margin size is an independent predictor of local tumor progression after ablation of colon cancer liver metastases
Abstract: Purpose: This study was designed to evaluate the relationship between the minimal margin size and local tumor progression (LTP) following CT-guided radiofrequency ablation (RFA) of colorectal cancer liver metastases (CLM). Methods: An institutional review board-approved, HIPPA-compliant review identified 73 patients with 94 previously untreated CLM that underwent RFA between March 2003 and May 2010, resulting in an ablation zone completely covering the tumor 4-8 weeks after RFA dynamic CT. Comparing the pre- with the post-RFA CT, the minimal margin size was categorized to 0, 1-5, 6-10, and 11-15 mm. Follow-up included CT every 2-4 months. Kaplan-Meier methodology and Cox regression analysis were used to evaluate the effect of the minimal margin size, tumor location, size, and proximity to a vessel on LTP. Results: Forty-five of 94 (47.9 %) CLM progressed locally. Median LTP-free survival (LPFS) was 16 months. Two-year LPFS rates for ablated CLM with minimal margin of 0, 1-5 mm, 6-10 mm, 11-15 mm were 26, 46, 74, and 80 % (p < 0.011). Minimal margin (p = 0.002) and tumor size (p = 0.028) were independent risk factors for LTP. The risk for LTP decreased by 46 % for each 5-mm increase in minimal margin size, whereas each additional 5-mm increase in tumor size increased the risk of LTP by 22 %. Conclusions: An ablation zone with a minimal margin uniformly larger than 5 mm 4-8 weeks postablation CT is associated with the best local tumor control. © 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Keywords: radiofrequency ablation; ablation; local tumor progression; ablation margin evaluation method; colon cancer liver metastasis; ct guided; image guided; minimal margin
Journal Title: CardioVascular and Interventional Radiology
Volume: 36
Issue: 1
ISSN: 0174-1551
Publisher: Springer  
Date Published: 2013-02-01
Start Page: 166
End Page: 175
Language: English
DOI: 10.1007/s00270-012-0377-1
PROVIDER: scopus
PUBMED: 22535243
PMCID: PMC4122121
Notes: --- - "Export Date: 1 February 2013" - "CODEN: CARAD" - "Source: Scopus"
Citation Impact
MSK Authors
  1. William Alago
    25 Alago
  2. Mithat Gonen
    782 Gonen
  3. Xiaodong Wang
    4 Wang
  4. Anne Covey
    134 Covey
  5. Kinh Gian Do
    146 Do
  6. Lynn Brody
    100 Brody
  7. Karen T Brown
    171 Brown
  8. Stephen Solomon
    306 Solomon
  9. Joseph Patrick Erinjeri
    112 Erinjeri
  10. Elena Nadia Petre
    58 Petre
  11. Nancy Kemeny
    437 Kemeny