For colorectal cancer patients with liver metastases, intraoperative rather than percutaneous ultrasound-guided radiofrequency ablation (RFA) may be preferable. Among its advantages, intraoperative RFA can be applied to multiple liver lesions, according to a study presented at the 2002 Society of Interventional Radiologists (SIR, formerly SCVIR) meeting in Baltimore.
Dr. Steve Raman and colleagues from the University of California, Los Angeles reviewed the ultrasound-guided RFA treatment of 59 liver metastases in 26 patients. The lesions ranged from 0.3-7.2 cm, with the goal of tissue ablation extending 5-10 mm beyond the tumor.
Local tumor control was defined as a lack of contrast enhancement on CT or MRI. Patients were followed for an average of six months. The review was designed to measure both the short-term impact of the procedure as well as the clinical benefit of the therapy.
The group reported that there were no immediate complications in the colon cancer patients studied. Initial contrast-enhanced CT or MRI exams showed no definite residual tumor (ablated margin of 1 cm). Over the follow-up period, six recurrent tumors were identified, and all of these patients were re-treated with percutaneous RFA. An abscess at the ablation site developed in one case.
The main advantage of intraoperative RFA is that it can be used when percutaneous RFA is contraindicated, and to treat multiple lesions or large lesions, they concluded. The intraoperative procedure also enables the concurrent placement of intra-arterial chemo-infusion pumps. The average hospital stay was six days, compared to percutaneous RFA, which can be as long as 10 days. Finally, the ultrasound images helped define the proper ablation volume, they said.
By Brian ReidAuntMinnie.com contributing writer
May 9, 2002
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