Patterns of Recurrence After Ablation of Colorectal Cancer Liver Metastases
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To determine the local recurrence rate and factors associated with recurrence after intraoperative ablation of colorectal cancer liver metastases.
A retrospective analysis of a prospectively maintained database was performed for patients who underwent ablation of a hepatic colorectal cancer metastasis in the operating room from April 1996 to March 2010. Kaplan-Meier survival curves and Cox models were used to determine recurrence rates and assess significance.
Ablation was performed in 10% (n = 158 patients) of all cases during the study period. Seventy-eight percent were performed in conjunction with a liver resection. Of the 315 tumors ablated, most tumors were ≤1 cm in maximum diameter (53%). Radiofrequency ablation was used to treat most of the tumors (70%). Thirty-six tumors (11%) had local recurrence as part of their recurrence pattern. Disease recurred in the liver or systemically after 212 tumors (67%) were ablated. On univariate analysis, tumor size greater than 1 cm was associated with a significantly increased risk of local recurrence (hazard ratio 2.3, 95% confidence interval 1.2–4.5, P = 0.013). The 2 year ablation zone recurrence-free survival was 92% for tumors ≤1 cm compared to 81% for tumors >1 cm. On multivariate analysis, tumor size of >1 cm, lack of postoperative chemotherapy, and use of cryotherapy were significantly associated with a higher local recurrence rate.
Intraoperative ablation appears to be highly effective treatment for hepatic colorectal tumors ≤1 cm.
KeywordsLiver Metastasis Liver Resection Local Recurrence Rate Colorectal Liver Metastasis Ablation Zone
- 5.Gold JS, Are C, Kornprat P, . Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome: trends in treatment over time in 440 patients. Ann Surg. 2008;247:109–17.PubMedCrossRefGoogle Scholar
- 13.House MG, Ito H, Gönen M, et al. Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. J Am Coll Surg. 2010;210:744–52, 752–5.Google Scholar