Langzeitüberleben nach laserinduzierter interstitieller Thermotherapie kolorektaler Lebermetastasen - ein Vergleich erster klinischer Erfahrungen mit aktuellen Behandlungsergebnissen

Abstract

Laser-induced interstitial thermotherapy (LITT) is a minimally invasive procedure for local tumor ablation. This report discusses the long-term results of this therapy in non-surgical patients with colorectal liver metastases. In total, we treated 163 colorectal liver metastases in 85 patients by MR-guided LITT. The overall lethality was 1.1%. The mean survival period of all treated patients was 3.3+/-0.3 years (CI: 2.8; 3.8; Kaplan-Meier method) with a calculation start date of the diagnosis of the metastases. The mean survival period after LITT was 2.6+/-0.2 years (CI 2.2; 3.0). There was a substantial learning curve with respect to the indication for LITT and the technical procedure of the intervention itself. In the first period (50 patients; 1998-2001), the mean survival period was 2.2+/-0.2 years (CI: 1.8; 2.7). Thereafter (35 patients 2001-2006), the mean survival period increased to 2.9+/-0.3 years (CI: 2.4; 3.4; log rank Test; p=0.0097). In the latter group, the 1-year survival rate was 93% and the 3-year survival rate was 56%. MR-guided LITT is a treatment suitable for non-surgical patients suffering from colorectal liver metastases. The complication rate of the procedure is comparatively low. The survival periods after the procedure are longer than those reported for similar patient populations after chemotherapy alone.