Radiofrequency Ablation of Hepatic Metastases After Curative Resection of Extrahepatic Cholangiocarcinoma

Abstract

The objective of our study was to retrospectively evaluate local control and survival after radiofrequency ablation (RFA) in patients with liver metastases arising from extrahepatic cholangiocarcinoma who had previously undergone curative resection. From May 2003 to May 2009, RFA using an internally cooled electrode was performed on 29 metachronous liver metastases (mean number of tumors per patient, 1.6) arising from extrahepatic cholangiocarcinoma in 18 patients (mean age, 66 years). Tumor size ranged from 0.9 to 4.6 cm in maximum dimension (mean, 2.3 cm). As historical comparisons, we included 24 patients diagnosed with recurrent metastasis limited to the liver between February 1997 and April 2003 and who met the inclusion criteria for RFA: 16 patients received supportive therapy only and eight patients underwent chemotherapy with or without radiation. Five patients had major complications (liver abscess, n = 4 patients; biliary stricture, n = 1; 17% per-treatment complication rate [5/29]), but there were no procedure-related deaths. Complete tumor necrosis was achieved in all 29 tumors after one session of RFA. The local tumor progression rate was 38% (median time to detection, 5 months). From the first diagnosis of liver metastasis, the median overall survival was 12.4 months and the 3-year survival rate was 10%. Patients who received RFA lived significantly longer than patients who received chemoradiotherapy (median survival, 5.6 months) and those who received supportive treatment (median survival, 5.3 months) (p < 0.001). Percutaneous RFA results in effective local tumor control and may prolong survival in patients with recurrent hepatic metastases after curative resection for extrahepatic cholangiocarcinoma.