Comparative study of resection and radiofrequency ablation in the treatment of solitary colorectal liver metastases

Hur, Hyuk; Ko, Yong; Min, Byung Soh; Kim, Kyung Sik; Choi, Jin Sub; Sohn, Seung Kook; Cho, Chang Hwan; Ko, Heung Kyu; Lee, Jong Tai; Kim, Nam Kyu

doi:10.1016/j.amjsurg.2008.04.013

Cited by 199 publications

(130 citation statements)

References 34 publications

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“…Meanwhile, some studies report good outcomes with resection and report the effectiveness of the RFA in special circumstances. Hur et al [16] report that the 5-year survival rates of 38 patients with small tumors (<3 cm) treated with HR and RFA were similar, including overall (56.1 vs. 55.4 %, p=0.451) and local recurrence-free (95.7 vs. 85.6 %, p=0.304) survival rates. Hence, RFA can be recommended as an alternative treatment for patients who are not candidates for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies indicate HR is superior to RFA [14][15][16]. Unfortunately, only 10-25 % of patients with colorectal liver metastases are candidates for HR; the others are not because of systemic conditions, underlying diseases, multiple liver metastases, and other problems [8][9][10]17].…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, several studies report better outcomes with HR than RFA. Hur et al [16] analyzed 42 and 25 patients who underwent HR and RFA, respectively, for the treatment of solitary colorectal liver metastases; the 5-year overall and local recurrence-free survival rates after HR (50.1 and 89.7 %, respectively) were significantly higher than those after RFA (25.5 and 69.7 %, respectively; p=0.0263 and 0.028, respectively). In addition, recurrence was significantly lower after HR.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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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“…Hyuk et al published a comparative study on 67 patients (42 liver resection vs 25 RFA) concerning the optimal treatment for solitary metastases, with results again in favor of liver resection. Survival at 3 and 5 years was superior in liver resection compared to RFA, regardless of the tumor size (<3 cm vs >3 cm), type (synchronous vs metachronous), location of liver metastases (central vs peripheral), postoperative chemotherapy or even recurrence rate [41].…”

Section: Rfa Vs Liver Resectionmentioning

confidence: 95%

Surgical hepatic resection vs. ultrasonographic guided radiofrequency ablation in colorectal liver metastases: what should we choose?

et al. 2014

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Clinical evolution of the colorectal carcinoma occurs in up to 60% with colorectal liver metastases (CRLM). Although hepatic resection is considered to be the golden standard in CRLM, novel less invasive techniques have emerged, of which radiofrequency ablation has received a high credibility. When tumors are not eligible for surgery, guided radiofrequency ablation is considered an alternative. This method is appropriate when there are no more than 5 lesions with a diameter of less than 3 cm. While open surgery guarantees a more precise tumor excision, the effectiveness of ablation must be evaluated either by contrast-enhanced computer tomography, magnetic resonance, or ultrasound. This paper aims to review the current standings in radiofrequency ablation for CRLM and to compare the technique with surgical resection in order to find which one is the best treatment option.

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“…RFA may be as effective as surgical therapy for solitary tumors of 3 cm or smaller (Abitabile et al 2007; Amersi et al 2006;Gwak et al 2011;Kim et al 2011;Kingham et al 2012;Siperstein et al 2007). The 5-year overall survival rate for RFA-treated patients with CLM varies widely between 14.3 % and 55.4 % (Gwak et al 2011;Hur et al 2009;Kim et al 2011). However, local tumor progression (LTP) remains a significant limitation of ablation (Mulier et al 2008;Sofocleous et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of YO-PRO-1 as an early marker of apoptosis following radiofrequency ablation of colon cancer liver metastases

et al. 2013

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Radiofrequency (RF) ablation (RFA) is a minimally invasive treatment for colorectal-cancer liver metastases (CLM) in selected nonsurgical patients. Unlike surgical resection, RFA is not followed by routine pathological examination of the target tumor and the surrounding liver tissue. The aim of this study was the evaluation of apoptotic events after RFA. Specifically, we evaluated YO-PRO-1 (YP1), a green fluorescent DNA marker for cells with compromised plasma membrane, as a potential, early marker of cell death. YP1 was applied on liver tissue adherent on the RF electrode used for CLM ablation, as well as on biopsy samples from the center and the margin of the ablation zone as depicted by dynamic CT immediately after RFA. Normal pig and mouse liver tissues were used for comparison. The same samples were also immunostained for fragmented DNA (TUN-EL assay) and for active mitochondria (anti-OxPhos antibody). YP1 was also used simultaneously with propidium iodine (PI) to stain mouse liver and samples from ablated CLM. Following RFA of human CLM, more than 90 % of cells were positive for YP1. In nonablated, dissected pig and mouse liver however, we found similar YP1 signals (93.1 % and 65 %, respectively). In samples of intact mouse liver parenchyma, there was a significantly smaller proportion of YP1 positive cells (22.7 %). YP1 and PI staining was similar for ablated CLM. However in dissected normal mouse liver there was initial YP1 positivity and complete absence of the PI signal and only later there was PI signal. Conclusion: This is the first time that YP1 was applied in liver parenchymal tissue (rather than cell culture). The results suggest that YP1 is a very sensitive marker of early cellular events reflecting an early and widespread plasma membrane injury that allows YP1 penetration into the cells.

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Comparative study of resection and radiofrequency ablation in the treatment of solitary colorectal liver metastases

Cited by 199 publications

References 34 publications

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

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

Surgical hepatic resection vs. ultrasonographic guided radiofrequency ablation in colorectal liver metastases: what should we choose?

Evaluation of YO-PRO-1 as an early marker of apoptosis following radiofrequency ablation of colon cancer liver metastases

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