Clinical

RF ablation curbs colorectal cancer liver metastasis

Last Updated: 2005-03-29 16:27:29 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Radiofrequency thermal ablation (RFA) appears to provide a survival advantage compared to chemotherapy alone in certain colorectal cancer patients with metastases to the liver, researchers report in the March issue of the Journal of Clinical Oncology.

Dr. Allan E. Siperstein of the Cleveland Clinic Foundation, Ohio, and colleagues note that although resection of hepatic metastases is standard treatment, as many as 20% of patients may not be candidates because of extensive disease or comorbidities.

To characterize predictors of survival in those who underwent laparoscopic RFA rather than resection, the researchers studied 135 such patients.

Following RFA, the median survival for all patients was 28.9 months. Patients with a cancer embryonic antigen level below 200 ng/mL had an improved survival (34 months) compared to those with a higher level (14 months).

Survival difference approached significance in patients with three or fewer tumors compared to those with more (29 months versus 22 months).

However, having a tumor larger than 5 cm was the only significant predictor of mortality. This carried a 2.5-fold increased risk of death, compared to having no tumor greater than 3 cm. The presence of extrahepatic disease did not affect survival.

The researchers note that, historically, survival with chemotherapy alone is 11 to 14 months, and they thus conclude that "RFA is a useful adjunct to chemotherapy in patients with liver-predominant disease."

J Clin Oncol 2005;23:1358-1364.