Skip to main content

Advertisement

SpringerLink
Log in

Radiofrequency Ablation of Hepatic Metastases: Factors Influencing Local Tumor Progression

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although radiofrequency ablation (RFA) of nonresectable hepatic metastases has gained wide acceptance by showing survival benefit in selected patients, scattered reports are available regarding risk factors of local control of percutaneous RFA. The purpose of this study was to prospectively evaluate the factors influencing local tumor progression after percutaneous RFA of hepatic metastases.

Methods

Sixty-nine hepatic metastatic lesions in 54 patients were treated by percutaneous RFA. Efficacy was evaluated by contrast-enhanced computed tomography or magnetic resonance imaging at 1 month after ablation, then at 3-month intervals for the first year and biannually thereafter.

Results

The results of the log-rank test showed that tumor size of <3 cm (p = 0.024) and the absence of tumor contiguous with large vessels (p = 0.002) significantly correlated with local control for hepatic metastases. Cox regression analysis showed that the tumor size <3 cm and the absence of tumor contiguous with large vessels were independent factors (p = 0.055 and 0.009, respectively). The results of the log-rank test showed that neither the threshold post-ablation margin of 1.8 cm (p = 0.064) nor the presence of a tumor with subcapsular location (p = 0.134) correlated with the success of local control.

Conclusions

Percutaneous RFA is more effective in achieving local control in patients with hepatic metastases when the tumor size is <3 cm and not contiguous with large vessels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Chen J, Tang Z, Dong X, et al. Radiofrequency ablation for liver metastasis from gastric cancer. Eur J Surg Oncol. 2013;39:701–6.

    Article  CAS  PubMed  Google Scholar 

  2. Park SY, Kim JH, Won HJ, Shin YM, Kim PN. Radiofrequency ablation of hepatic metastases after curative resection of extrahepatic cholangiocarcinoma. AJR Am J Roentgenol. 2011;197:1129–34.

    Article  Google Scholar 

  3. Namasivayam S, Martin DR, Saini S. Imaging of liver metastases: MRI. Cancer Imaging. 2007;7:2–9.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Chiou YY, Chou YH, Chiang JH, Wang HK, Chang CY. Percutaneous ultrasound-guided radiofrequency ablation of colorectal liver metastases. Chin J Radiol. 2005;30:153–8.

    Google Scholar 

  5. Tateishi R, Shiina S, Teratani T, et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma. an analysis of 1000 cases. Cancer. 2005;103:1201–9.

    Google Scholar 

  6. Shibata T, Shibata T, Maetani Y, Isoda H, Hiraoka M. Radiofrequency ablation for small hepatocellular carcinoma: prospective comparison of internally cooled electrode and expandable electrode. Radiology. 2006;238:346–53.

    Article  PubMed  Google Scholar 

  7. Livraghi T, Solbiati L, Meloni F, Ierace T, Goldberg SN, Gazelle GS. Percutaneous radiofrequency ablation of liver metastases in potential candidates for resection: the “test-of-time” approach. Cancer. 2003;97:3027–35.

    Article  PubMed  Google Scholar 

  8. Liu CH, Arellano RS, Uppot RN, Samir AE, Gervais DA, Mueller PR. Radiofrequency ablation of hepatic tumours: effect of post-ablation margin on local tumour progression. Eur Radiol. 2010;20:877–85.

    Article  PubMed  Google Scholar 

  9. Weiss L, Grundmann E, Torhorst J, et al. Haematogenous metastatic patterns in colonic carcinoma: an analysis of 1541 necropsies. J Pathol. 1986;150:195–203.

    Article  CAS  PubMed  Google Scholar 

  10. Curley SA, Izzo F, Deirio P, et al. Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg. 1999;230:1–8.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Ksienski D, Woods R, Speers C, Kennecke H. Patterns of referral and resection among patients with liver-only metastatic colorectal cancer (MCRC). Ann Surg Oncol. 2010;17:3085–93.

    Article  PubMed  Google Scholar 

  12. Pockaj BA, Wasif N, Dueck AC, et al. Matastasectomy and surgical resection of the primary tumor in patients with stage IV breast cancer: time for a second look? Ann Surg Oncol. 2010;17:2419–26.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Saxena A, Chua TC, Sarkar A, et al. Progression and survival after radical hepatic matastasectomy of indolent advance neuroendocrine neoplasms (NENs) supports an aggressive surgical approach. Surgery. 2011;149:209–20.

    Article  PubMed  Google Scholar 

  14. Mazzaferro V, Battiston C, Perrone S, et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg. 2004;240:900–9.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Gillams AR, Lees WR. Radiofrequency ablation of colorectal liver metastases. Abdom Imaging. 2005;30:419–26.

    Article  CAS  PubMed  Google Scholar 

  16. Sartori S, Tombesi P, Macario F, et al. Subcapsular liver tumors treated with percutaneous radiofrequency ablation: a prospective comparison with nonsubcapsular liver tumors for safety and effectiveness. Radiology. 2008;248:670–9.

    Article  PubMed  Google Scholar 

  17. Gervais DA, Arellano RS, Mueller PR. Percutaneous radiofrequency ablation of ovarian cancer metastasis to the liver: indications, outcomes, and role in patient management. AJR Am J Roentgenol. 2006;187:746–50.

    Article  PubMed  Google Scholar 

  18. Komorizono Y, Oketani M, Sako K, et al. Risk factors for local recurrence of small hepatocellular carcinoma tumors after a single session, single application of percutaneous radiofrequency ablation. Cancer. 2003;97:1253–62.

    Article  PubMed  Google Scholar 

  19. Montgomery RS, Rahal A, Dodd GD 3rd, Leyendecker JR, Hubbard LG. Radiofrequency ablation of hepatic tumors: variability of lesion size using a single ablation device. AJR Am J Roentgenol. 2004;182:657–61.

    Article  PubMed  Google Scholar 

  20. Hansler J, Frieser M, Tietz V, et al. Percutaneous radiofrequency ablation of liver tumors using multiple saline-perfused electrodes. J Vasc Interv Radiol. 2007;18:405–10.

    Article  PubMed  Google Scholar 

  21. Harrison LE, Koneru B, Baramipour P, et al. Locoregional recurrences are frequent after radiofrequency ablation for hepatocellular carcinoma. J Am Coll Surg. 2003;197:759–64.

    Article  PubMed  Google Scholar 

  22. An JY, Kim JY, Choi MG, et al. Radiofrequency ablation for hepatic metastasis from gastric adenocarcinoma. Yonsei Med J. 2008;49:1046–51.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Ng KK, Poon RT. Radiofrequency ablation for malignant liver tumor. Surg Oncol. 2005;14:41–52.

    Article  PubMed  Google Scholar 

  24. Cady B, Jenkins RL, Steele GD, et al. Surgical margin in hepatic resection for colorectal metastasis: a critical and improvable determinant of outcome. Ann Surg. 1998;227:566–71.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Nakazawa T, Kokubu S, Shibuya A, et al. Radiofrequency ablation of hepatocellular carcinoma: correlation between local tumor progression after ablation and ablative margin. AJR Am J Roentgenol. 2007;188:480–8.

    Article  PubMed  Google Scholar 

  26. Hori T, Nagata K, Hasuike S, et al. Risk factors for local recurrence of hepatocellular carcinoma tumors after a single session of percutaneous radiofrequency ablation. J Gastroenterol. 2003;38:977–81.

    Article  PubMed  Google Scholar 

  27. Tung-Ping Poon R, Fan ST, Wong J. Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma. Ann Surg. 2000;232:10–24.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Kim YS, Lee WJ, Rhim H, Lim HK, Choi D, Lee JY. The minimal ablative margin of radiofrequency ablation of hepatocellular carcinoma (>2 and <5 cm) needed to prevent local tumor progression: 3D quantitative assessment using CT image fusion. AJR Am J Roentgenol. 2010;195:758–65.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

Supported in part by a grant from Tri-Service General Hospital (TSGH C99-052). The Institutional Review Board for Human Investigation of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB 098-05-260), approved this study.

Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, R.O.C.

    Chang-Hsien Liu MD, Chih-Yung Yu MD & Wei-Chou Chang MD

  2. Division of Oncology, Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, R.O.C.

    Ming-Shen Dai MD, PhD

  3. Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, R.O.C.

    Cheng-Wen Hsiao MD

  4. School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C.

    Yu-Ching Chou PhD

Authors
  1. Chang-Hsien Liu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chih-Yung Yu MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wei-Chou Chang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ming-Shen Dai MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cheng-Wen Hsiao MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yu-Ching Chou PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chang-Hsien Liu MD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, CH., Yu, CY., Chang, WC. et al. Radiofrequency Ablation of Hepatic Metastases: Factors Influencing Local Tumor Progression. Ann Surg Oncol 21, 3090–3095 (2014). https://doi.org/10.1245/s10434-014-3738-y

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-014-3738-y

Keywords

Search

Navigation