Radiofrequency Ablation in Patients With Primary and Secondary Hepatic Malignancies

Meijer, Vincent E de; Verhoef, Cornelis; Kuiper, Jan Willem; Alwayn, I. P. J.; Kazemier, Geert; IJzermans, Jan N.M.

doi:10.1016/j.gassur.2006.03.003

Cited by 36 publications

(25 citation statements)

References 49 publications

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“…Lesions treated with RFA have local recurrence rates of 4% to 55%. 10,29 Crude local control rates of 78-100% are reported in tumor-based analysis after SRx. 30 RFA has achieved an important role for patients unfit for surgery with small (<3 cm) liver metastases.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 For patients with a small liver remnant after major hepatectomy, RFA or SRx were alternatives if the metastases were <3 cm. 10,11 RFA was first treatment option, but in case of ill location of the metastases (nearby main vessel and/or bile ducts), SRx was the alternative.…”

Section: Methodsmentioning

confidence: 99%

“…10 SRx was mostly given in three fractions of 15 Gy, and the prescription isodose was 65%. 11 Data analyzed included demographics, pathological tumor-node-metastases stage of the primary tumor, maximum size and number of metastases on computed tomography (CT), plasma carcinoembryonic antigen (CEA) level, type of liver surgery, overall duration of hospital stay, complications, radicality, site, and treatment of recurrence.…”

Section: Methodsmentioning

confidence: 99%

“…[4][5][6][7][8][9] Recent technologic advances have also made local ablative treatments for liver tumors accessible. 10 Patients with small central recurrences after a prior major liver resection and patients who are poor candidates for surgery are often treated by radiofrequency ablation (RFA). Stereotactic body radiation therapy (SRx) is another emerging local treatment option for patients with intrahepatic malignancies not eligible for surgery or RFA.…”

Section: Introductionmentioning

confidence: 99%

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Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Pool

Lalmahomed

Wilt

et al. 2009

Journal of Gastrointestinal Surgery

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Objective The objective of the study was to identify patients who may benefit from local treatment in recurrent colorectal liver metastases. Materials and methods A total of 51 consecutive patients were treated for hepatic recurrence(s) after an initial partial hepatic resection. Surgery was considered as the primary treatment option for eligible patients. Patients with a small liver remnant after major hepatectomy were treated with radiofrequency ablation (RFA) or stereotactic body radiation therapy (SRx). SRx was given as an outpatient, emerging local treatment option for patients with intra-hepatic recurrences not eligible for surgery or RFA. Partial liver resection was performed in 36 patients (70%), RFA in ten patients (20%), and SRx in five patients (10%). Results Median hospital stay was 7 (range, 3-62) days with a morbidity of 16% without in-hospital death. None of the patients received adjuvant chemotherapy. There was no difference in recurrence or survival between the three treatment modalities. Overall 5-year survival was 35% with an estimated median survival of 37 months. Patients with a disease-free interval between first hepatectomy and hepatic recurrence less than 6 months did not survive 3 years. Conclusions Resection, RFA, and SRx can be performed safely in patients with recurrent colorectal liver metastases and offer a survival that seems comparable to primary liver resections of colorectal liver metastases.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Pool

Lalmahomed

Wilt

et al. 2009

Journal of Gastrointestinal Surgery

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“…Six studies found superior local control rates for the open surgical approach compared to the percutaneous approach [79,81,82,83,84,85]. Data on local recurrence rate after the less frequently used laparoscopic approach are harder to find.…”

Section: Oncological Arguments With Direct Evidence Pro and Contra Rfmentioning

confidence: 99%

Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?

et al. 2008

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Background: A recent proposal of a randomized trial comparing resection and radiofrequency ablation (RFA) in a selected subgroup of patients with small resectable colorectal liver metastases (CRLM) has initiated a debate on this issue. Meanwhile, new data have been published. The aim of the study was to update and critically review the oncological evidence in favor of and against the use of RFA for resectable CRLM in general and in favor of and against conducting a randomized trial in a selected subgroup of patients. Methods: An exhaustive review was carried out of papers and abstracts on RFA of colorectal metastases published before July 15, 2008. Results: Local recurrence rate after resection of CRLM is 1.2–10.4%. Local recurrence rate after RFA of CRLM is between 1.7 and 66.7%. For tumors <3 cm, local control after open RFA is equivalent to resection. Local recurrence rates, however, are higher for larger tumors and for the percutaneous and laparoscopic route. Accumulating evidence suggests that RFA and resection induce profoundly different biological effects, which may influence survival. Conclusions: Local recurrence rate after open RFA for CRLM <3 cm seems to be equivalent to resection. A randomized trial under strict conditions would be justified in this subgroup of patients. A randomized trial is currently not justified for larger tumors or for percutaneous or laparoscopic RFA, since local recurrence rates in these groups are too high to be acceptable for resectable tumors.

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Stereotactic body radiation therapy for colorectal liver metastases

Pool

Romero

Wunderink

et al. 2010

British Journal of Surgery

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Radiofrequency Ablation in Patients With Primary and Secondary Hepatic Malignancies

Cited by 36 publications

References 49 publications

Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Local Treatment for Recurrent Colorectal Hepatic Metastases after Partial Hepatectomy

Radiofrequency Ablation versus Resection for Resectable Colorectal Liver Metastases: Time for a Randomized Trial?

Stereotactic body radiation therapy for colorectal liver metastases

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