Short term and long term results of patients with colorectal liver metastases undergoing surgery with or without radiofrequency ablation

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Congress:

ECR 2015

Poster Number:

C-1318

Type:

Scientific Exhibit

Keywords:

Abdomen, Liver, Ultrasound, Intraoperative, Metastases

Authors:

M. J. van Amerongen¹, J. J. Futterer¹, S. F. M. Jenniskens¹, H. de Wilt¹, E. van der Stok², D. J. Grünhagen², C. Verhoef², A. Moelker²; ¹Nijmegen/NL, ²Rotterdam/NL

DOI:

10.1594/ecr2015/C-1318

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-1318

Table 1: Table of significant different patient characteristics

Table 2: Table of postoperative results

Fig. 1: Figure of Disease-free survival (DFS) and Overall Survival (OS) for both groups

Table 3: Table of multivariate analysis results

Aims and objectives

Colorectal cancer is a very common disease, listing currently as third and second most diagnosed carcinoma in respectively men and females. These patients will develop liver metastases in up to 50% of cases (1, 2). The gold standard for curative treatment in patients with colorectal liver metastasis (CRLM) is conventional hepatic surgery. However, surgery is only possible in 10-25% of patients with CRLM, due to several oncologic criteria for unresectability, such as a lack of reserve liver parenchyma, presence of extrahepatic disease or ill location...

Methods and materials

For the treatment of CRLM, 1007 patients were prospectively included in a multicenter database of two university hospitals in the Netherlands between January 2000 and May 2013. Of this database, 632 patients were included after exclusion of patients with extrahepatic disease, two-staged operation of their disease, synchronous surgery of both primary tumor and liver metastasis or loss of follow-up. Both patients who received only surgery and the intraoperative combination with RFA, received an open approach operation. After mobilization, the liver was inspected using palpation and...

Results

The combination group consisted of 98 patients, while 534 patients were included in the only surgery group. There was no significant difference between the two groups with regard to gender (P=0.99), age (P=0.42), BMI (P=0.53), location of primary tumor (P=0.80) or the maximal size of metastasis (P=0.24). Significantly different patient characteristics were a better ASA classification for the combination group due to more patients treated with ASA II (P=0.04). However, no difference was found in total comorbidities of patients (P=0.91). Patients in the combination group...

Conclusion

The combination of intraoperative RFA and hepatic resection of CRLM is a safe treatment option which doesn’t increase the chances of postoperative complications. The difference in DFS between the two groups can be explained by the difference in the oncologic Fong CRS. The Fong CRS also has an effect on the difference in OS, however a possible explanation could also be the lower amount of curative treatment options in case of recurrence in the combination group, as is demonstrated in the results. Since the patients...

Personal information

References

1. Siegel R, Desantis C, Jemal A. Colorectal cancer statistics, 2014. CA: a cancer journal for clinicians. 2014;64(2):104-17. Epub 2014/03/19. 2. Benson AB, 3rd. Epidemiology, disease progression, and economic burden of colorectal cancer. J Manag Care Pharm. 2007;13(6 Suppl C):S5-18. Epub 2007/10/13. 3. Clancy C, Burke JP, Barry M, Kalady MF, Calvin Coffey J. A Meta-Analysis to Determine the Effect of Primary Tumor Resection for Stage IV Colorectal Cancer with Unresectable Metastases on Patient Survival. Annals of surgical oncology. 2014;21(12):3900-8. Epub 2014/05/23. 4. Ayez N,...