Percutaneous radiofrequency ablation of colorectal cancer liver metastases: Factors affecting outcomes-a 10-year experience at a single center Journal Article
| Authors: | Shady, W.; Petre, E. N.; Gonen, M.; Erinjeri, J. P.; Brown, K. T.; Covey, A. M.; Alago, W.; Durack, J. C.; Maybody, M.; Brody, L. A.; Siegelbaum, R. H.; D'Angelica, M. I.; Jarnagin, W. R.; Solomon, S. B.; Kemeny, N. E.; Sofocleous, C. T. |
| Article Title: | Percutaneous radiofrequency ablation of colorectal cancer liver metastases: Factors affecting outcomes-a 10-year experience at a single center |
| Abstract: | Purpose: To identify predictors of oncologic outcomes after percutaneous radiofrequency ablation (RFA) of colorectal cancer liver metastases (CLMs) and to describe and evaluate a modified clinical risk score (CRS) adapted for ablation as a patient stratification and prognostic tool. Materials and Methods: This study consisted of a HIPAA-compliant institutional review board-approved retrospective review of data in 162 patients with 233 CLMs treated with percutaneous RFA between December 2002 and December 2012. Contrast material-enhanced CT was used to assess technique effectiveness 4-8 weeks after RFA. Patients were followed up with contrast-enhanced CT every 2-4 months. Overall survival (OS) and local tumor progression-free survival (LTPFS) were calculated from the time of RFA by using the Kaplan-Meier method. Log-rank tests and Cox regression models were used for univariate and multivariate analysis to identify predictors of outcomes. Results: Technique effectiveness was 94% (218 of 233). Median LTPFS was 26 months. At univariate analysis, predictors of shorter LTPFS were tumor size greater than 3 cm (P <001), ablation margin size of 5 mm or less (P <001), high modified CRS (P = .009), male sex (P = .03), and no history of prior hepatectomy (P = .04) or hepatic arterial infusion chemotherapy (P = .01). At multivariate analysis, only tumor size greater than 3 cm (P = .01) and margin size of 5 mm or less (P <001) were independent predictors of shorter LTPFS. Median and 5-year OS were 36 months and 31%. At univariate analysis, predictors of shorter OS were tumor size larger than 3 cm (P = .005), carcinoembryonic antigen level greater than 30 ng/mL (P = .003), high modified CRS (P = .02), and extrahepatic disease (EHD) (P <001). At multivariate analysis, tumor size greater than 3 cm (P = .006) and more than one site of EHD (P <001) were independent predictors of shorter OS. Conclusion: Tumor size of less than 3 cm and ablation margins greater than 5 mm are essential for satisfactory local tumor control. Tumor size of more than 3 cm and the presence of more than one site of EHD are associated with shorter OS. © RSNA, 2015. |
| Keywords: | adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; antibiotic agent; major clinical study; overall survival; outcome assessment; colorectal cancer; progression free survival; computer assisted tomography; tumor volume; carcinoembryonic antigen; retrospective study; lung embolism; liver metastasis; pneumothorax; contrast enhancement; vein thrombosis; fluorodeoxyglucose f 18; comorbidity; liver resection; electroporation; pleura effusion; sex difference; bacteremia; clinical effectiveness; cryoablation; radiofrequency ablation; urine retention; microwave therapy; biloma; oncological parameters; bladder catheterization; liver hematoma; human; male; female; priority journal; article |
| Journal Title: | Radiology |
| Volume: | 278 |
| Issue: | 2 |
| ISSN: | 0033-8419 |
| Publisher: | Radiological Society of North America, Inc. |
| Date Published: | 2016-02-01 |
| Start Page: | 601 |
| End Page: | 611 |
| Language: | English |
| DOI: | 10.1148/radiol.2015142489 |
| PROVIDER: | scopus |
| PMCID: | PMC4734163 |
| PUBMED: | 26267832 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 March 2016 -- Source: Scopus |
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