Original scientific paper
Radiofrequency Ablation as Locoregional Therapy for Unresectable Hepatic Malignancies: Initial Results in 24 Patients with 5-Years Follow-Up
Mate Majerović
Goran Augustin
Željko Jelinčić
Damir Buković
Tihomir Kekez
Petar Matošević
Dubravko Smuđ
Emil Kinda
Ante Zvonimir Golem
Abstract
Radiofrequency ablation (RFA) is one treatment modality for unresectable liver metastases. Patients with hepatic malignancies
(n=24) underwent elective RFA. All tumors were ablated with a curative intent, with a margin of 1 cm, in a
single session of RFA. The median diameter of tumor was 3.1 cm (range 1.7–6.9 cm). Studied patients were not candidates
for resection due to multifocal hepatic disease, extrahepatic disease, proximity to major vascular structures or presence
of cirrhosis with functional hepatic reserve inadequate to tolerate major hepatic resection. Complete tumor necrosis
was achieved in 87.5% and tumor recurred in 3 patients (12.5%) with lesions larger than 5 cm. Distant intrahepatic recurrence
was diagnosed in another 4 (16.7%). Distant metastases were found in 7 (29.2%) patients. Four of these 7 patients
had also distant intrahepatic recurrence of disease. Two and 5-years survival rates were 41.7% (10 patients) and
8.3% (2 patients) respectively. RFA is safe and effective option for patients with unresectable hepatic malignancies
smaller than 5 cm without distant metastatic disease. RF ablation resulted in complete tumor necrosis in 87.5% with 2
and 5-years survival rates much higher than with chemotherapy alone or only supportive therapy, when survival is measured
in weeks or months. If RFA is unavailable, percutaneous ethanol injection therapy can be done but with inferior
survival rates.
Keywords
radiofrequency ablation; liver metastases; recurrence; percutaneous ethanol injection; mortality
Hrčak ID:
27044
URI
Publication date:
2.9.2008.
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