Radiofrequency Ablation in the treatment of hepatic colorectal metastases: Mid-term results

Radyofrequency ablation(RFA) is a widely used technique for local control of unresectable primary and metastatic liver tumors. The aim of this study is to evaluate the effectiveness and mid-term results after RFA in the treatment of hepatic colorectal metastases.58 patients (37 men, 21 women; mean age 58 years, age range 32-84) with 278 hepatic colorectal metastases were involved in this study. 260 of the lesions were treated with RFA and 18 lesions were resected. All patients also received chemotherapy. The number of ablated lesions were between 1 to 11 (mean=5) and the largest diameter of lesions were between 1 to 9 cm.(mean=2,2 cm.). A total of 93 sessions of RFA were performed (33 intraoperative, 60 percutaneous). During percutaneous ablations, ultrasound (US) guidance was used in 56 sessions and a combination of US and CT guidance was preferred in 4 sessions. ?RITA Starbust Talon? electrode was used in all RFA procedures. Before the treatment of peripherally located lesions (40 lesions in 22 cases), 5 % dextrose solution was injected into the peritoneal cavity with 18 gauge Chiba needle to isolate the liver. After RFA, patients were followed-up with CT and MRI at the first, sixth months and then with intervals of six months.In one of the patients, skin burn was developed after tract ablation. In four patients pleural effusion, in six patients abscesses in the ablation area, and in one patient bilier duct damage and cholecystitis were developed. In one patient abscess in ablation area and then jejunal fistula was occured. Follow-up periods were between 1 to 48 months (mean follow-up=17 months). In the first follow-up examination, complete ablation was observed in 50/58 (86 %) of the cases. 35 sessions of repeat RFA was performed in 18/58 (31 %) cases with recurrences. During the follow-up period, in 8/58 (14 %) widespread hepatic metastases and in 18/58 (31 %)) extrahepatic disease was developed. 12/58 (21 %) of the cases were lost due to disseminated disease.RFA is an effective treatment alternative in cases with hepatic colorectal metastases. Intraperitoneal dextrose injection provides safe ablation of more lesions and increases the number of patients suitable for ablation therapy.