Efficacy of radiofrequency ablation in the treatment of hepatic metastases of non-colorectal cancers

Objective: To determine the efficacy of radiofrequency ablation (RFA) method in treatment of hepatic metastases of non-colorectal cancers.
Material and Method: This retrospective cohort included 28 patients (17 women, 11 men) diagnosed with a total of 101 hepatic metastases of non-colorectal cancers. RFA under sonographic guidance was administered to 95 (94.1%) of lesions, while surgical resection was performed for 6 (5.9%) metastases. At the time of diagnosis, 10 (35.7%) of patients had a single lesion; whereas 18 (64.3%) patients had multiple lesions. Average number of ablated lesions was 2 (range, 1 to 6) and their average diameter was 2.4 cm (range, 0.9-5.2 cm). All patients routinely received chemoradiotherapy.
Results: Portal venous thrombosis and liver abscess were detected after RFA in 1 (3.5%) and 2 patients (7%), respectively. Mean duration of follow-up was 17 months (range, 1-51 months) and complete ablation was accomplished in 17 (76%) of our series. Thirteen sessions of repetitive RFA was performed in 7 cases with recurrent disease. During the follow-up period, widespread hepatic metastases and extra hepatic disease were encountered in 6 (21%) and 16 (57%) patients, respectively. Mortality occurred in 9 (32%) patients due to disseminated disease.
Conclusion: Our results indicate that RFA can be a promising therapeutic alternative in patients with hepatic metastasis of non-colorectal cancers, particularly breast cancer and neuroendocrine tumors. Number of lesions is the most important parameter likely to affect the overall and disease free rates of survival.

Kolorektal dýþý kanserlerin karaciðer metastazlarýnda radyofrekans ablasyon yöntemininin etkinliðinin deðerlendirilmesi

Amaç: Kolorektal dýþý kanserlerin karaciðer metastazlarýnda radyofrekans ablasyon (RFA) yönteminin tedavideki etkinliðinin deðerlendirilmesi.
Gereç ve Yöntem: Karaciðere metastatik kolorektal dýþý kanser tanýsý almýþ, toplam lezyon sayýsý 101 olan 28 hasta (17 kadýn, 11 erkek) retrospektif kohort çalýþmamýza dahil edildi. Çalýþmamýzda 95 (%94.1) lezyona ultrasonografi eþliðinde RFA uygulanýrken, 6 (%5.9) lezyona cerrahi rezeksiyon yapýlmýþtý. Taný anýnda 10 (%35.7) olguda tek lezyon, 18 (%64.3) olguda multipl lezyon bulunmaktaydý. Ablasyon yapýlan ortalama lezyon sayýsý 2 (1-6) ve ortalama boyut 2.4 (0.9-5.2) cm olarak belirlendi. Tüm olgular kemoradyoterapi almýþtý.
Bulgular: RFA sonrasý 1 (%3.5) olguda portal ven trombozu, 2 olguda (%7) karaciðer apsesi geliþti. Ortalama takip süresi 17 (1-51) aydý. 17 (%76) olguda ilk takipte tam ablasyon saðlandý. Rekürrens saptanan 7 olguda 13 seans reRFA uygulandý. Takipte 6 (%21) olguda yaygýn hepatik metastaz, 16 (%57) olguda karaciðer dýþý hastalýk izlendi. 9 (%32) olgu yaygýn hastalýk nedeniyle kaybedildi.
Sonuç: Sonuçlarýmýz RFA’nýn kolorektal dýþý kanserlerin karaciðer metastazlarýnda, özellikle de meme kanseri ve nöroendokrin tümörlere ait metastazlarda umut verici bir tedavi alternatifi olduðunu göstermektedir. Hastalýksýz ve genel saðkalýmý etkileyen en önemli parametre ise lezyon sayýsý olarak görülmektedir.