Korean J Radiol.  2011 Oct;12(5):579-587. 10.3348/kjr.2011.12.5.579.

Radiofrequency Ablation for Treating Liver Metastases from a Non-Colorectal Origin

• Yun BL
• Lee JM
• Baek JH
• Kim SH
• Lee JY
• Han JK
• Choi BI

• KMID: 1116443
• DOI: http://doi.org/10.3348/kjr.2011.12.5.579

Abstract

OBJECTIVE
We wanted to assess the safety and efficacy of performing radiofrequency ablation (RFA) in patients with non-colorectal liver metastases.
MATERIALS AND METHODS
In this retrospective study, 25 patients with 40 hepatic metastases (M:F = 17:8; mean age, 57 years; tumor size, 0.5-5.0 cm) from a non-colorectal origin (stomach, biliary, breast, pancreas, kidney and skin) were treated with RFA. The RFA procedures were performed using either an internally cooled electrode or a clustered electrode under ultrasound or CT guidance. Contrast-enhanced CT scans were obtained immediately after RFA and follow-up CT scans were performed within three months after ablation and subsequently at least every six months. The intrahepatic disease-free interval was estimated and the overall survival from the time of the initial RFA was analyzed using the Kaplan-Meier method.
RESULTS
No intraprocedural deaths occurred, but four major complications developed, including abscesses (n = 3) and pneumothorax (n = 1). Technical effectiveness was determined on the initial follow-up images. During the follow-up period (range, 5.9-68.6 months; median time, 18.8 months) for 37 tumors in 22 patients where technical effectiveness was achieved, 12 lesions (32%, 12 of 37) showed local tumor progression and new intrahepatic metastases occurred in 13 patients (59%, 13 of 22). The median intrahepatic disease-free interval was 10.1 months. The 1-year, 3-year and 5-year overall survival rates after RFA were 86%, 39% and 19%, respectively.
CONCLUSION
RFA showed intermediate therapeutic effectiveness for the treatment of non-colorectal origin liver metastases.

Keyword

Liver; Interventional procedures; Radiofrequency ablation; Preliminary clinical study

MeSH Terms

Adult
Aged
Aged, 80 and over
*Catheter Ablation/adverse effects
Disease Progression
Disease-Free Survival
Female
Humans
Liver Neoplasms/mortality/radiography/*secondary/*surgery
Male
Middle Aged
Neoplasm Recurrence, Local
Radiography, Interventional
Tomography, X-Ray Computed
Ultrasonography, Interventional

Figure

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  Fig. 1 Imaging findings are shown for approximately 3.6 cm sized gastric cancer liver metastasis that was completely ablated (technical success) without recurrence. A-E. Pre-ablation contrast-enhanced CT in equilibrium phase (A) shows 3.6 cm sized peripheral enhancing mass located at segment 7. Immediate-ablation dynamic contrast-enhanced CT demonstrates complete necrosis of metastasis with lack of enhancement on early arterial (B), late arterial (C) and portal venous (D) phase. After eight months, follow-up contrast-enhanced CT image (E) shows cystic change of ablated lesion without evidence of recurrence.

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  Fig. 2 Rates of local tumor progression after radiofrequency ablation.

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  Fig. 3 Rates of intrahepatic remote recurrence after radiofrequency ablation.

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  Fig. 4 Intrahepatic tumor-free interval after radiofrequency ablation.

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  Fig. 5 Survival rate after radiofrequency ablation.

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