Results after simultaneous surgery and RFA liver ablation for patients with colorectal carcinoma and synchronous liver metastases

M J van Amerongen; E P van der Stok; J J Fütterer; S F M Jenniskens; A Moelker; C Verhoef; D J Grünhagen; J H W de Wilt

doi:10.1016/j.ejso.2019.07.016

Results after simultaneous surgery and RFA liver ablation for patients with colorectal carcinoma and synchronous liver metastases

Eur J Surg Oncol. 2019 Dec;45(12):2334-2339. doi: 10.1016/j.ejso.2019.07.016. Epub 2019 Jul 7.

Authors

M J van Amerongen¹, E P van der Stok², J J Fütterer³, S F M Jenniskens⁴, A Moelker⁵, C Verhoef², D J Grünhagen², J H W de Wilt⁶

Affiliations

¹ Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands. Electronic address: Martin.vanAmerongen@radboudumc.nl.
² Department of Surgical Oncology, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, the Netherlands.
³ Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands; MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Drienerlolaan 5, PO Box: 217, 7500 AE, Enschede, the Netherlands.
⁴ Department of Radiology, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands.
⁵ Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute Rotterdam, 's Gravendijkwal 230, PO Box: 2040, 3000 CA, Rotterdam, the Netherlands.
⁶ Department of Surgery, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, PO Box: 9101, 6500HB, Nijmegen, the Netherlands.

PMID: 31301939
DOI: 10.1016/j.ejso.2019.07.016

Abstract

Background: Approximately 20% of patients with colorectal cancer present with synchronous liver metastases (sCRLM). These patients can be treated with a "one-step procedure" or staged resection, with or without radiofrequency ablation (RFA). Colorectal surgery in combination with intraoperative RFA leads to concerns regarding postoperative complications and survival. The purpose was to evaluate the one-step procedure with or without RFA in patients with sCRLM.

Materials and methods: Between January 2000 and September 2018, patients with sCRLM were selected in two tertiary referral centers and retrospectively analyzed. Postoperative morbidity and survival were analyzed.

Results: From a total of 410 patients presenting with sCRLM, 329 patients underwent a staged resection and 81 a one-step procedure. The 3-year overall survival (OS) was respectively 66% and 69% for one-step procedure and staged resection (P = 0.24). A total of 18 patients underwent RFA during the one step procedure. No significant differences were shown in postoperative complications whether intraoperative RFA was used in patients with sCRLM. In the one-step procedure, the 3-year OS was respectively 43% and 72% wheter patients did or did not receive RFA (P = 0.19).

Conclusion: OS for patients with sCRLM was similar for both one-step procedure and staged resection. Intraoperative RFA for sCRLM is technically safe.

Keywords: Colorectal neoplasms; Hepatectomy; Liver; Radiofrequency catheter ablation.

Publication types

Multicenter Study

MeSH terms

Aged
Catheter Ablation / methods*
Colorectal Neoplasms / mortality
Colorectal Neoplasms / pathology
Colorectal Neoplasms / surgery*
Female
Hepatectomy / methods*
Humans
Liver Neoplasms / mortality
Liver Neoplasms / pathology
Liver Neoplasms / surgery*
Male
Middle Aged
Neoplasms, Multiple Primary / mortality
Neoplasms, Multiple Primary / pathology
Neoplasms, Multiple Primary / surgery*
Netherlands
Postoperative Complications
Retrospective Studies
Survival Rate