Effectiveness of radiofrequincy ablation technique in the treatment of hepatic non-colorectal metastases

Liver involvelment is the most common cause of death in cancer patiens. Lung cancer, pancreatic cancer, gastric cancer, breast cancer and the cancers of unknown primary are the most frequentnon-colorectal cancers which metastase to the liver. Usually surgery is the first treatment option in the primary and secondary tumors of liver. But unfortunately small amount of patients can be candidates for resection. Metastasectomy can make longer survival rates in selected patients with colorectal cancer but there is no significant effectiveness in non-colorectal tumors. The aim of this study is to determine the effectiveness of radiofrequincy ablation (RFA) teqhnique in the treatment of hepatic non-colorectal metastases. 28 patients (11 men, 17 women; mean age 56 years, age range 38-79) with 99 non-colorectal liver metastases were involved in this study. 95(94,1%) of the lesions were treated with RFA and6 (5,9%) lesions were resected. At the time of diagnose 10 (35,7%) patients had one lession and 18 (64,3%) patients had more than one lession. All patients also received chemotherapy and or radiotherapy. The number of ablated lesions were between 1 to 6 (mean=2) and the largest diameter of lesions were between 0,9 to 5,2 cm.(mean=2,4 cm; <4cm n=24, >4cm n=4). A total of 34 sessions of RFA were performed. During ablations, ultrasound (US) guidance was used in all sessions. ?RITA Starbust Talon? electrode was used in all RFA procedures. After RFA, patients were followed-up with CT and MRI at the first, sixth months and then with intervals of six months. One patient (7%) had portal venos thrombosis and two patiens (3,5%) had liver abscesses related to RFA procedure. Follow-up periods were between 1 to 51 months (mean follow-up=17 months). In the first follow-up examination, complete ablation was observed in 17/28 (76 %) of the cases. 13 sessions of repeat RFA was performed in 7/28 (25 %) cases with recurrences. During the follow-up period, in 6/28 (21 %) widespread hepatic metastases and in 16/28 (57 %) extrahepatic disease developed. 9/28 (32 %) of the cases died due to disseminated disease. RFA is an important technique which can be used as an alternative or additional choice of treatment in cases with hepatic non-colorectal metastases. Number of lesions is the most important fact that can effect overall and diseasefree survival. Specially at the breast cancer and neuroendocrine tumor liver metastases results are very promising. Key words: Hepatic Non-colorectal Metastases, Radiofrequency Ablation, Interventional Radiology.