Recurrence and Outcomes Following Hepatic Resection, Radiofrequency Ablation, and Combined Resection/Ablation for Colorectal Liver Metastases

Abdalla, Eddie K.; Vauthey, Jean‐Nicolas; Ellis, Lee M.; Ellis, Vickie; Pollock, Raphael E.; Broglio, Kristine; Hess, Kenneth R.; Curley, Steven A.

doi:10.1097/01.sla.0000128305.90650.71

Cited by 1,586 publications

(1,091 citation statements)

References 22 publications

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“…In humans, RFA has been shown to be more effective than chemotherapy for the clinical treatment of metastatic cancer patients with minimal liver lesions (32). On the other hand, RFA treatment does not show any advantage in long-term survival compared to surgery in metastatic cancer patients (33).…”

Section: Discussionmentioning

confidence: 99%

RFA strongly modulates the immune system and anti-tumor immune responses in metastatic liver patients

et al. 2008

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Abstract. Radiofrequency tumor ablation (RFA) is a therapeutic modality for liver cancer patients inducing localized tumor necrosis with maximal preservation of normal liver parenchyma. We investigated the immunomodulatory effects exerted by RFA treatment in liver cancer patients with metastatic liver lesions (13 patients) or hepatocellular carcinoma (HCC) (4 patients). Analysis of lymphocyte subsets by flow cytometry revealed that after RFA, CD3 + T cells, in particular CD4 + , were decreased in metastatic cancer patients, while no change was observed in HCC patients. Moreover, RFA induced trafficking of naïve and memory CD62L + T cells from circulation to tissues. When characterizing the function of T cells, proliferative response to PHA was strongly increased after 48 h from RFA in metastatic cancer patients. Furthermore, T cells produced IFN-γ in response to the tumor associated MUC1 antigen. In contrast, humoral immune responses against tumor antigens such as MUC1 and HCV proteins were unaffected by RFA treatment, although increase of circulating B cells was observed only in metastatic cancer patients. These results indicate that RFA application can exert an activating effect on the immune system in metastatic cancer patients, favouring trafficking of lymphocyte subsets and enhancing tumor antigen specific cellular immune responses.

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Section: Discussionmentioning

confidence: 99%

RFA strongly modulates the immune system and anti-tumor immune responses in metastatic liver patients

et al. 2008

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“…Lesions up to 3 cm can be treated by RF, both percutaneously or surgically (laparoscopy or laparotomy). Usually patients are treated with RF when damage does not spread outside the liver or when there it is possibility to control (or can control) the extrahepatic disease 2,17 . Most centers consider the patient treatable with up to four liver lesions.…”

Section: Methods Of Tumor Ablationmentioning

confidence: 99%

Estratégias para aumentar a ressecabilidade em pacientes com metástases hepáticas de tumores colorretais

Perini¹,

Coelho²,

Makdissi³

et al. 2011

ABCD, arq. bras. cir. dig.

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-Introduction: Nowadays, liver resections can be performed with acceptable morbi-mortality rates. In specialized centers, mortality as low as 1% can be achieved, even with the advent of new hepatotoxic chemotherapy regimens. In order to reduce morbidity and mortality, newer strategies can be undertaken, such as portal vein embolization, radiofrequency ablation techniques, re-hepatectomies, major vascular resections and two stages hepatectomies. Method -Literature review was conducted on sites search PubMed, BIREME, SciELO, with the headings "partial hepatectomy, hepatic metastases, colorectal cancer, radiofrequency and embolization". Were selected mainly studies with the application of techniques and surgical procedures in the treatment of liver metastasis. Conclusion -Survival rates as good as 50% in 5y can be achieved in selected cases when a multidisciplinary team is involved. Better surgical techniques, with parenchimal sparing strategies and the advent of neoadjuvant chemotherapy can turn unresectable liver lesions to resectable and increase survival rates. ABCDDV/820RESUMO -Introdução -Atualmente, as ressecções hepáticas podem ser realizadas com taxas aceitáveis de morbimortalidade. Em centros especializados, mortalidade ao redor de 1% pode ser alcançada, mesmo em fígados previamente submetidos à quimioterapia por longo prazo. Com o objetivo de reduzir essas taxas, novas estratégias têm sido empregadas, como a embolização portal, ablação por radiofrequência, re-hepatectomias ressecções vasculares com reconstrução e hepatectomias em dois tempos. Método -Foi realizada revisão de literatura nos sites de pesquisa PubMed, Bireme e Scielo, com os descritores "hepatectomias parciais, metástases, neoplasia colorretal, radiofrequência e embolização". Selecionaram-se, principalmente, os estudos de aplicação de técnicas e procedimentos cirúrgicos no tratamento das metástases hepáticas. Conclusão -Sobrevida ao redor de 50% em cinco anos podem ser conseguidas em casos selecionados quando equipe multidisciplinar está envolvida no tratamento. Com a melhora na técnica operatória, poupando-se parênquima hepático, e com o advento de novos agentes quimioterápicos, lesões metastáticas hepáticas irressecáveis podem se tornar ressecáveis e a sobrevida a longo prazo pode ser alcançada.

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“…However, the 5-year survival rate with hepatic resection (HR) is reported to range from 23 to 58 %. Therefore, HR has been recognized as the standard treatment for liver metastasis [5][6][7]. Nevertheless, some clinical conditions such as unfavorable tumor location, insufficient hepatic reserve, disease extent, and medical comorbidities make HR difficult.…”

Section: Introductionmentioning

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%

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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Recurrence and Outcomes Following Hepatic Resection, Radiofrequency Ablation, and Combined Resection/Ablation for Colorectal Liver Metastases

Abstract: Hepatic resection is the treatment of choice for colorectal liver metastases. RFA alone or in combination with resection for unresectable patients does not provide survival comparable to resection, and provides survival only slightly superior to nonsurgical treatment.

Cited by 1,586 publications

References 22 publications

RFA strongly modulates the immune system and anti-tumor immune responses in metastatic liver patients

RFA strongly modulates the immune system and anti-tumor immune responses in metastatic liver patients

Estratégias para aumentar a ressecabilidade em pacientes com metástases hepáticas de tumores colorretais

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

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