1274: Factors Influencing Complete Tumor Destruction (CTD), Local Tumor Progression (LTP) and Survival after Radiofrequency Ablation of Metastatic Liver Tumors

Abstract

ObjectiveTo research on the factors influencing CTD, LTP, and survival after US-guided percutaneous RFA in patients with liver metastases.Methods133 patients (276 metastases) were treated using monopolar, 36 patients (65 metastases) – with multipolar and 8 patients (11 lesions) – with expandable RFA, in a 6-year period. Tumor size was 3.38±1.82cm (0.5-11.5) and was larger in the multipolar and expandable groups. The achieved destruction was assessed with CT, CEUS and biopsy. Patients were followed-up for 1-47 months. Binary logistic, Cox-regression, and Kaplan-Meier analysis were implemented.ResultsCTD was achieved in 70.7% of the lesions after monopolar, 71.4% after multipolar, and in 10/11 lesions after expandable RFA, depending on the size, applied RF energy and location, but not on the origin of primary tumor. LTP per lesion was 31.5% after monopolar and 18.2% after multipolar RFA, depending on the size and applied energy. Achievement of CTD of all lesions per patient depended on the size of the largest lesion and number of lesions. The probability of LTP and time to LTP per patient depended on the size of the largest lesion, number of lesions and subsequent chemotherapy. Median survival was 42 months. Cumulative 36-month survival was 91.4%. The size of the largest lesion, achievement of CD of all lesions and additional chemotherapy significantly influenced survival.ConclusionMultipolar and expandable RFA are preferable in medium-sized and large lesions, monopolar RFA is suitable for difficult locations. CTD of all lesions and multidisciplinary approach to the patients with liver metastases lengthens survival. ObjectiveTo research on the factors influencing CTD, LTP, and survival after US-guided percutaneous RFA in patients with liver metastases. To research on the factors influencing CTD, LTP, and survival after US-guided percutaneous RFA in patients with liver metastases. Methods133 patients (276 metastases) were treated using monopolar, 36 patients (65 metastases) – with multipolar and 8 patients (11 lesions) – with expandable RFA, in a 6-year period. Tumor size was 3.38±1.82cm (0.5-11.5) and was larger in the multipolar and expandable groups. The achieved destruction was assessed with CT, CEUS and biopsy. Patients were followed-up for 1-47 months. Binary logistic, Cox-regression, and Kaplan-Meier analysis were implemented. 133 patients (276 metastases) were treated using monopolar, 36 patients (65 metastases) – with multipolar and 8 patients (11 lesions) – with expandable RFA, in a 6-year period. Tumor size was 3.38±1.82cm (0.5-11.5) and was larger in the multipolar and expandable groups. The achieved destruction was assessed with CT, CEUS and biopsy. Patients were followed-up for 1-47 months. Binary logistic, Cox-regression, and Kaplan-Meier analysis were implemented. ResultsCTD was achieved in 70.7% of the lesions after monopolar, 71.4% after multipolar, and in 10/11 lesions after expandable RFA, depending on the size, applied RF energy and location, but not on the origin of primary tumor. LTP per lesion was 31.5% after monopolar and 18.2% after multipolar RFA, depending on the size and applied energy. Achievement of CTD of all lesions per patient depended on the size of the largest lesion and number of lesions. The probability of LTP and time to LTP per patient depended on the size of the largest lesion, number of lesions and subsequent chemotherapy. Median survival was 42 months. Cumulative 36-month survival was 91.4%. The size of the largest lesion, achievement of CD of all lesions and additional chemotherapy significantly influenced survival. CTD was achieved in 70.7% of the lesions after monopolar, 71.4% after multipolar, and in 10/11 lesions after expandable RFA, depending on the size, applied RF energy and location, but not on the origin of primary tumor. LTP per lesion was 31.5% after monopolar and 18.2% after multipolar RFA, depending on the size and applied energy. Achievement of CTD of all lesions per patient depended on the size of the largest lesion and number of lesions. The probability of LTP and time to LTP per patient depended on the size of the largest lesion, number of lesions and subsequent chemotherapy. Median survival was 42 months. Cumulative 36-month survival was 91.4%. The size of the largest lesion, achievement of CD of all lesions and additional chemotherapy significantly influenced survival. ConclusionMultipolar and expandable RFA are preferable in medium-sized and large lesions, monopolar RFA is suitable for difficult locations. CTD of all lesions and multidisciplinary approach to the patients with liver metastases lengthens survival. Multipolar and expandable RFA are preferable in medium-sized and large lesions, monopolar RFA is suitable for difficult locations. CTD of all lesions and multidisciplinary approach to the patients with liver metastases lengthens survival.