Use of intraoperative ablation as an adjunct to surgical resection in the treatment of recurrent colorectal liver metastases Journal Article

  

Authors:	Govindarajan, A.; Arnaoutakis, D.; D'Angelica, M.; Allen, P. J.; DeMatteo, R. P.; Blumgart, L. H.; Jarnagin, W. R.; Fong, Y.
Article Title:	Use of intraoperative ablation as an adjunct to surgical resection in the treatment of recurrent colorectal liver metastases
Abstract:	Objective: To evaluate the role of intraoperative ablation as an adjunct to resection in patients with recurrent colorectal liver metastases (rCLM). Methods: All patients undergoing curative-intent reoperative surgery for rCLM from 1992 to 2009 at a tertiary cancer center were included. Overall survival (OS) and recurrence-free survival (RFS) were compared between patients treated with resection alone or in combination with ablation. Results: A total of 112 reoperative hepatectomies were performed, of which 16 were combined with ablation. The proportion of patients treated with resection and ablation increased from 0% to 41%. Patients undergoing resection and ablation had a greater tumor burden (median, 4 vs. 1, p < 0.0001) and higher baseline clinical risk scores (median, 3 vs. 2, p = 0.065) than patients undergoing resection alone. Patients undergoing resection and ablation had lower intraoperative blood loss than patients undergoing resection alone (344 vs. 877 ml, p = 0.018). Five-year OS from the time of surgery was 48.6%. In multivariable analysis, there was no significant difference in OS or RFS based on the treatment modality. Conclusion: In patients with rCLM, the use of intraoperative ablation can extend the limits of surgical resection in patients with disease that might otherwise not be amenable to complete resection. © 2011 The Society for Surgery of the Alimentary Tract.
Keywords:	treatment outcome; disease-free survival; middle aged; survival rate; retrospective studies; mortality; liver neoplasms; united states; comparative study; disease free survival; follow up; methodology; follow-up studies; colorectal cancer; metastasis; neoplasm recurrence, local; risk factors; pathology; retrospective study; risk factor; colorectal neoplasms; intraoperative period; colorectal tumor; tumor recurrence; liver tumor; surgery; liver resection; hepatectomy; new york; catheter ablation; liver metastases; ablation
Journal Title:	Journal of Gastrointestinal Surgery
Volume:	15
Issue:	7
ISSN:	1091-255X
Publisher:	Springer
Date Published:	2011-07-01
Start Page:	1168
End Page:	1172
Language:	English
DOI:	10.1007/s11605-011-1470-5
PROVIDER:	scopus
PUBMED:	21557021
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-79958829877&partnerID=40&md5=fe8e31e7b76380aaea9d5a123863a3a9
Notes:	--- - "Export Date: 17 August 2011" - "Source: Scopus"

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