Comparative analysis of radiofrequency ablation and surgical resection for colorectal liver metastases

Kim, Kyung Ho; Yoon, Yong Sik; Yu, Chang Sik; Kim, Tae Won; Kim, Hye Jin; Kim, Pyo Nyun; Ha, Hyun Kwon; Kim, Jin Cheon

doi:10.4174/jkss.2011.81.1.25

Cited by 117 publications

(105 citation statements)

References 30 publications

(41 reference statements)

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“…Some centres treat up to nine tumours, if the maximum diameter is <4 cm, and usually at two treatment sessions [48,49]. As in the resection literature, the best results are achieved in solitary tumours, Gillams et al [32] reported 3-year survival in excess of 80 % and Kim et al [50] reported 5-year survival of 51 % in solitary tumours. Additional tumours that develop during follow-up, including new tumours in the postresection liver remnant or local recurrence, should be considered for ablation based upon anatomical and size criteria.…”

Section: Tumour Numbermentioning

confidence: 99%

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

et al. 2015

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Objectives Previous attempts at meta-analysis and systematic review have not provided clear recommendations for the clinical application of thermal ablation in metastatic colorectal cancer. Many authors believe that the probability of gathering randomised controlled trial (RCT) data is low. Our aim is to provide a consensus document making recommendations on the appropriate application of thermal ablation in patients with colorectal liver metastases. Methods This consensus paper was discussed by an expert panel at The Interventional Oncology Sans Frontières 2013. A literature review was presented. Tumour characteristics, ablation technique and different clinical applications were considered and the level of consensus was documented.Eur Radiol (2015) Results Specific recommendations are made with regard to metastasis size, number, and location and ablation technique. Mean 31 % 5-year survival post-ablation in selected patients has resulted in acceptance of this therapy for those with technically inoperable but limited liver disease and those with limited liver reserve or co-morbidities that render them inoperable.Conclusions In the absence of RCT data, it is our aim that this consensus document will facilitate judicious selection of the patients most likely to benefit from thermal ablation and provide a unified interventional oncological perspective for the use of this technology. Key Points• Best results require due consideration of tumour size, number, volume and location.• Ablation technology, imaging guidance and intraprocedural imaging assessment must be optimised.• Accepted applications include inoperable disease due to tumour distribution or inadequate liver reserve.• Other current indications include concurrent co-morbidity, patient choice and the test-of-time approach.• Future applications may include resectable disease, e.g. for small solitary tumours.

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Section: Tumour Numbermentioning

confidence: 99%

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

et al. 2015

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“…Neuere Arbeiten legen die Vermutung nahe, dass bei solitären Lebermetastasen < 3 cm mittels RFA ähnlich gute Ergebnisse wie durch die Resektion erzielt werden können [712,713]. Die bisherige Datenlage hierzu ist aber widersprüchlich und es fehlen weiterhin vergleichende kontrollierte-randomisierte Studien.…”

Section: Level Of Evidence 3aunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

148

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“…Hence, RFA can be recommended as an alternative treatment for patients who are not candidates for surgery. Kim et al [20] claim that RFA is a safe alternative treatment for solitary colorectal liver metastases <3 cm, with outcomes equivalent to those achieved with HR. Furthermore, Gillams et al [21] report that RFA for solitary liver metastases ≤4 cm can be performed with minimal morbidity and results in excellent long-term survival, approaching that of surgical resection, even in patients who are not candidates for surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hepatic Resection and Radiofrequency Ablation for the Treatment of Colorectal Liver Metastasis

Kim

et al. 2015

Indian J Surg

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The liver is the major site of metastasis of primary colorectal cancer. Hepatic resection (HR) is considered the standard treatment for colorectal liver metastasis. In highrisk cases, radiofrequency ablation (RFA) can be attempted as an alternative treatment. This study compared the clinical profiles and overall and disease-free survival rates of patients with colorectal liver metastasis undergoing HR and RFA. From 1995 to 2009, we retrospectively analyzed clinical experiences of 43 and 17 patients who had undergone HR and RFA for primary colorectal cancer, respectively. To compare outcomes, we investigated the 3-year overall and disease-free survival rates. The 3-year overall survival rates of patients treated with HR and RFA were 53.5 and 47.1 %, respectively (p=0.285); the disease-free survival rates were 35.0 and 26.9 %, respectively (p=0.211). In the HR and RFA groups, 30 (60.2 %) and 13 (76.5 %) patients developed recurrence, respectively (p=0.604). In the HR group, 1 patient died from postoperative liver failure, and 9 (20.9 %) developed postoperative complications, including wound infection, biliary leakage, intra-abdominal abscess, and pneumonia. In the RFA group, 1 patient (5.9 %) required prolonged inpatient care because of a procedure-related liver abscess. Although HR should be considered the first option for colorectal liver metastasis, RFA can be regarded as a primary treatment modality depending on the patient's characteristics, especially when a patient refuses surgery or has comorbidities.

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Comparative analysis of radiofrequency ablation and surgical resection for colorectal liver metastases

Cited by 117 publications

References 30 publications

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, the interventional oncology sans frontières meeting 2013

S3-Leitlinie – Kolorektales Karzinom

Comparison of Hepatic Resection and Radiofrequency Ablation for the Treatment of Colorectal Liver Metastasis

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