Long-Term Outcomes Following Hepatic Resection and Radiofrequency Ablation of Colorectal Liver Metastases

McKay, Andrew; Fradette, Katherine; Lipschitz, Jeremy

doi:10.1155/2009/346863

Cited by 51 publications

(52 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both laparoscopic and open RF ablation carry a higher morbidity, require general anaesthesia, entail a longer hospital stay and increased cost, and should be reserved for specific indications. Open RF ablation without resection still carries a small mortality (<2.3 %) and the major complication rate varies between 9.6 % and 32 % (Table 2) [34,41,42]. Therefore the percutaneous approach is favoured.…”

Section: Strongmentioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Strongmentioning

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

View full text Add to dashboard Cite

show abstract

“…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%

“…These findings suggest that RFA should be considered only for selected patients with unresectable disease or high operative risk. Meanwhile, McKay et al [14] also report that RFA is inferior to resection. In their study, the 5-year survival rate after resection was 43 % compared to 23 % after RFA; for patients with solitary lesions, the 5-year survival was 48 % after resection and 15 % after RFA.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, many researchers report RFA to be less invasive as well as more safer than HR; the advantage of RFA lies in the fact that it can be performed repeatedly for recurrence or new metastases [11][12][13]. However, the therapeutic outcomes of RFA are reported to be inferior to those of HR [7,14], and studies published hitherto report the use of RFA primarily for surgically unresectable cases. Several recent studies reported the practice of performing RFA for resectable colorectal liver metastasis [15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Kim

et al. 2015

Indian J Surg

View full text Add to dashboard Cite

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.

show abstract

“…• Radiofrequency ablation has been used for unresectable metastasis, sometimes in conjunction with the surgical removal of resectable metastases, and may have a role in the treatment of other selected patients [26][27][28][29] .…”

Section: 12mentioning

confidence: 99%

Liver Resection for Colorectal Cancer Metastases

et al. 2013

View full text Add to dashboard Cite

These recommendations apply to patients with liver metastases from crc who have had or will have a complete (R0) resection of the primary cancer and who are being considered for resection of the liver, or liver plus specific and limited ehms, with curative intent. 1(a). Patients with liver and lung metastases should be seen in consultation with a thoracic surgeon. Combined or staged metastasectomy is recommended when, taking into account anatomic and physiologic considerations, the assessment is that all pulmonary metastases can also be completely removed. Furthermore, liver resection may be indicated in patients who have had a prior lung resection, and vice versa. 1(b). Routine liver resection is not recommended in patients with portal nodal disease. This group includes patients with radiologically suspicious portal nodes or malignant portal nodes found preoperatively or intraoperatively. Liver plus nodal resection, together with perioperative systemic therapy, may be an option-after a full discussion with the patient-in cases with limited nodal involvement and with metastases that can be completely resected. 1(c). Routine liver resection is not recommended in patients with nonpulmonary ehms. Liver plus extrahepatic resection, together with perioperative systemic therapy, may be an option-after a full discussion with the patient-for metastases that can be completely resected. 2(a). Perioperative chemotherapy, either before and after resection, or after resection, is recommended in patients with resectable ABSTRACT Questions1. Should surgery be considered for colorectal cancer (crc) patients who have liver metastases plus (a) pulmonary metastases, (b) portal nodal disease, or (c) other extrahepatic metastases (ehms)? 2. What is the role of chemotherapy in the surgical management of crc with liver metastases in (a) patients with resectable disease in the liver, or (b) patients with initially unresectable disease in the liver that is downsized with chemotherapy ("conversion")? 3. What is the role of liver resection when one or more crc liver metastases have radiographic complete response (rcr) after chemotherapy? PerspectivesAdvances in chemotherapy have improved survival in crc patients with liver metastases. The 5-year survival with chemotherapy alone is typically less than 1%, although two recent studies with folfox or folfoxiri (or both) reported rates of 5%-10%. However, liver resection is the treatment that is most effective in achieving long-term survival and offering the possibility of a cure in stage iv crc patients with liver metastases. This guideline deals with the role of chemotherapy with surgery, and the role of surgery when there are liver metastases plus ehms. Because only a proportion of patients with crc metastatic disease are considered for liver resection, and because management of this patient population is complex, multidisciplinary management is required. MethodologyRecommendations in the present guideline were formulated based on a prepublication version of a recent systematic review on th...

show abstract

Long-Term Outcomes Following Hepatic Resection and Radiofrequency Ablation of Colorectal Liver Metastases

Cited by 51 publications

References 34 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

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

Liver Resection for Colorectal Cancer Metastases

Contact Info

Product

Resources

About